| NPI | 1457190472 |
|---|---|
| Former Name | ISABELLA AMYTHYST RUSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 372600000X Adult Companion |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2025-04-13 |