| NPI | 1417288325 | 
|---|---|
| Former Name | KATHRYN DOREMUS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10004501A)  | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA002432)  | 
| 363AM0700X Physician Assistant, Medical (Licence: PA MA54269)  | |
| 363A00000X Physician Assistant (Licence: NC 0010-11127)  | |
| Enumeration Date | 2010-01-18 | 
| Last Update Date | 2025-01-15 |