| NPI | 1346516770 |
|---|---|
| Former Name | KELLY L GONZALEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT27240) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 10043) |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2020-03-12 |