| NPI | 1326305145 |
|---|---|
| Former Name | KATHRYN RENEE FONTAINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0005089) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C05089) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2015-07-17 |