Individual
LIDIA RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN CNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
COA 11047 NP
OH
Other
Enumeration date
10/07/2009
Last updated
10/07/2009
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