| NPI | 1912296625 |
|---|---|
| Former Name | NICOLE FOX JAVELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME147841) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0116023408) |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA 144755) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2021-07-09 |