| NPI | 1437505062 |
|---|---|
| Former Name | ELIZABETH ANN SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD H89594) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101022767) |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2023-10-31 |