| NPI | 1306133772 |
|---|---|
| Former Name | ANGIE MARIE GUTIERREZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-04368) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2011020651) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2019-08-22 |