| NPI | 1497161251 |
|---|---|
| Former Name | MARVELLA DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 247200000X Technician, Other |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2020-07-16 |