| NPI | 1255826376 |
|---|---|
| Former Name | KRISTEN RUSSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OK 34604) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE TEP8298) |
| Enumeration Date | 2018-06-30 |
| Last Update Date | 2019-05-10 |