| NPI | 1255908091 | 
|---|---|
| Former Name | KRISTEN GRACE DINSMORE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5220)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 5220)  | 
| Enumeration Date | 2021-06-09 | 
| Last Update Date | 2024-09-18 |