| NPI | 1003126285 |
|---|---|
| Former Name | KRISTIN DERMODY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110003427) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-02818) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA056117) | |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2015-06-30 |