| NPI | 1871506329 |
|---|---|
| Former Name | MICHELA MARGARET RUSSO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN RN0000045493) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2007-07-08 |