NPI | 1295330694 |
---|---|
Former Name | KATHERINE TINAJERO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61511235) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA2358) |
363A00000X Physician Assistant (Licence: CA 58655) | |
Enumeration Date | 2020-12-02 |
Last Update Date | 2024-04-30 |