Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 11751224-1205 | UT |
Y | 207RP1001X | Pulmonary Disease | 11751224-1205 | UT |
NPI | 1013364744 |
---|---|
Provider Name | Katarina Wrzos |
First Address | Salt Lake City, UT 84132-0002 |
Second Address | Salt Lake City, UT 84132-0002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2016 |
Last Update Date | 11/06/2020 |