NPI | 1275074825 |
---|---|
Former Name | MICHELLE NOGALSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-06690) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2017026982) |
Enumeration Date | 2017-03-15 |
Last Update Date | 2021-04-28 |