| NPI | 1326532037 |
|---|---|
| Former Name | JANIKA PATRICIA SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0979) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ND PAC0979) |
| 363AM0700X Physician Assistant, Medical (Licence: CA 55665) | |
| 363AS0400X Physician Assistant, Surgical (Licence: NV PA2149) | |
| Enumeration Date | 2018-06-16 |
| Last Update Date | 2023-12-27 |