| NPI | 1972780062 |
|---|---|
| Former Name | LORETTA SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 49624) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A100131) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2025-04-28 |