| NPI | 1275198327 |
|---|---|
| Former Name | IRENE ELIZABETH RUSSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: TN 25855) |
| Additional Taxonomies | 163WE0003X Registered Nurse Emergency (Licence: TN 198102) |
| 363LF0000X Nurse Practitioner Family (Licence: TN 25855) | |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2022-11-29 |