| NPI | 1033136650 |
|---|---|
| Former Name | KIMBERLY LYNN RUSSO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 236721) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 054658) |
| 207P00000X Emergency Medicine (Licence: IL 036-113760) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2011-03-29 |