NPI | 1356537989 |
---|---|
Former Name | CHRISTIE ANN SULLIVAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60546976) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA19348) |
Enumeration Date | 2007-09-18 |
Last Update Date | 2022-04-15 |