NPI | 1629204391 |
---|---|
Former Name | ANGELA DAWN SULLIVAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX U4267) |
Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: IN 01068980A) |
208D00000X General Practice (Licence: IN 01068980A) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2009-06-08 |
Last Update Date | 2024-08-19 |