NPI | 1275965329 |
---|---|
Former Name | SARA LENNON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085004769) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085-004769) |
Enumeration Date | 2013-07-31 |
Last Update Date | 2023-03-07 |