| NPI | 1356646087 |
|---|---|
| Former Name | ROBERTA CHRISTINE RUSSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX AP119780) |
| Additional Taxonomies | 364SF0001X Clinical Nurse Specialist Family Health (Licence: TX 648686) |
| Enumeration Date | 2011-01-11 |
| Last Update Date | 2016-08-29 |