| NPI | 1588957807 |
|---|---|
| Former Name | COLLEEN LENNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50006441RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA054221) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2020-08-17 |