NPI | 1073755146 |
---|---|
Former Name | JANIE MIRANDA MEZA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2020037712) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AR PT4144) |
Enumeration Date | 2009-04-03 |
Last Update Date | 2020-11-08 |