Individual
XAVIER DOMINIQUE LENNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110004660
VA
363AM0700X
Medical Physician Assistant
C0004156
MD
363AM0700X
Medical Physician Assistant
PA030607
DC
363AS0400X
Surgical Physician Assistant
Primary
C04156
MD
Other
Enumeration date
08/21/2009
Last updated
12/14/2020
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