| NPI | 1639282692 |
|---|---|
| Former Name | LORI D RUSSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 001004941) |
| Additional Taxonomies | 2083B0002X Preventive Medicine, Obesity Medicine (Licence: NC 001004941) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2024-04-09 |