| NPI | 1447525654 |
|---|---|
| Former Name | LARISSA ANN GREGORY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: CT 63953) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2024-05-17 |