Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 02004360A | IN |
N | 111NI0900X | Internist | 02004360A | IN |
Y | 207RR0500X | Rheumatology | 02004360A | IN |
NPI | 1013283845 |
---|---|
Provider Name | Dr. Katrina Marie Lawrence-Wolff |
First Address | Fort Sam Houston, TX 78234-4504 |
Second Address | Fort Sam Houston, TX 78234-4504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2012 |
Last Update Date | 24/01/2020 |