Individual
MISS RACHEL ANN RUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
25MP00263600
NJ
363AS0400X
Surgical Physician Assistant
Primary
PA5737
MA
Other
Enumeration date
11/15/2011
Last updated
01/25/2017
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