| NPI | 1225337132 |
|---|---|
| Former Name | LARISSA IVANOVNA RUN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA1268) |
| Additional Taxonomies | 174400000X Specialist (Licence: NV PA1268) |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2024-10-10 |