| NPI | 1326205675 |
|---|---|
| Former Name | DENISE IRENE SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 5372) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P5372) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2025-04-15 |