NPI | 1720134919 |
---|---|
Former Name | APRIL MARLENE SULLIVAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0065251) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 155484) |
207R00000X Internal Medicine (Licence: VA 0101237499) | |
Enumeration Date | 2007-01-28 |
Last Update Date | 2013-02-06 |