NPI | 1093770356 |
---|---|
Former Name | CAROLYN ANN SULLIVAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MD D40265) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MD D40265) |
Enumeration Date | 2006-04-19 |
Last Update Date | 2024-05-02 |