| NPI | 1245624097 |
|---|---|
| Former Name | LAURA ELIZABETH LARUSSO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.133961) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX Q9478) |
| 208000000X Pediatrics (Licence: CA A128586) | |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2019-04-01 |