| NPI | 1770871576 |
|---|---|
| Professional Name | MARY IRENE GONZALES MIRANDA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 21825) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 16685) |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2019-09-25 |