NPI | 1720811607 |
---|---|
Former Name | ALLISON HENDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3540) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: KY TC021) |
Enumeration Date | 2024-08-26 |
Last Update Date | 2025-09-22 |