| NPI | 1639282692 |
|---|---|
| Former Name | LORI D RUSSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2006-00920) |
| Additional Taxonomies | 207RB0002X Internal Medicine, Bariatric Medicine (Licence: NC 2006-00920) |
| 2083B0002X Preventive Medicine, Obesity Medicine (Licence: NC 2006-00920) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2025-04-11 |