| NPI | 1366763807 |
|---|---|
| Former Name | JILL R RUSSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NE 29011) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MO 2011036407) |
| 207K00000X Allergy & Immunology (Licence: CO DR.0067275) | |
| 208000000X Pediatrics (Licence: MO 2011036407) | |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2021-10-04 |