| NPI | 1356048086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROXANNA LAROQUE Director Of Client Experience 210-714-5647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2023-02-13 |