| NPI | 1689697476 |
|---|---|
| Former Name | KATHLEEN KELLY SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC R61983) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-07-08 |