Individual
MINA NA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
414 PAOLI PIKE, MALVERN, PA 19355-3311
(484) 596-5400
Mailing address
414 PAOLI PIKE, MALVERN, PA 19355-3311
(848) 596-5400
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
C2-0024682
DE
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OS021742
PA
Other
Enumeration date
04/26/2018
Last updated
03/04/2025
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