| NPI | 1134882780 |
|---|---|
| Former Name | MICHELE WISE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MO 2021021766) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: KS 17-03778) |
| Enumeration Date | 2021-10-20 |
| Last Update Date | 2021-10-20 |