NPI | 1154758845 |
---|---|
Former Name | KRISTEN TAYLOR MCCORMICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: TX R7123) |
Additional Taxonomies | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: TX BP10058779) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-09-26 |
Last Update Date | 2021-04-13 |