| NPI | 1912957770 |
|---|---|
| Former Name | K THERESE SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 41391) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 40516) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2007-07-08 |