| NPI | 1992174858 |
|---|---|
| Former Name | SARAH DIANNE HEADLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA5483) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00421100) |
| 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00421100) | |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2016-12-27 |