| NPI | 1316354863 |
|---|---|
| Former Name | KENDRA ALISE SAMMONS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110005955) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA1941) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2020-02-11 |