NPI | 1689954034 |
---|---|
Former Name | EMILY D RUSSELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 007385) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 332301) |
363L00000X Nurse Practitioner (Licence: CT 007385) | |
363LF0000X Nurse Practitioner, Family (Licence: NM 336800) | |
Enumeration Date | 2011-08-17 |
Last Update Date | 2022-03-14 |