| NPI | 1700492493 |
|---|---|
| Former Name | SHELBY VICTORIA GUTIERREZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT014823) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 38197) |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2024-01-29 |