| NPI | 1629204391 |
|---|---|
| Former Name | ANGELA DAWN SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: IN 01068980A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 01068980A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2023-08-08 |