| NPI | 1164916680 |
|---|---|
| Former Name | JORIE ELIZABETH SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.141964) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2021-06-29 |