| NPI | 1992190433 |
|---|---|
| Former Name | AMY SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CT 69411) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA10505900) |
| 207V00000X Obstetrics & Gynecology (Licence: VA 0101268763) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2022-02-25 |