| NPI | 1578979936 |
|---|---|
| Former Name | KRISTEN ELIZABETH WHITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NC 0010-05741) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00339000) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2015-07-01 |