NPI | 1972173300 |
---|---|
Former Name | SUMMER CHRISTINE OVERHOLT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA12765300) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT222967) |
208100000X Physical Medicine & Rehabilitation (Licence: PA MT222967) | |
Enumeration Date | 2021-06-28 |
Last Update Date | 2025-07-07 |