| NPI | 1821282773 |
|---|---|
| Former Name | LISA MICHELLE SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R1568949) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2008-12-22 |