| NPI | 1588849756 |
|---|---|
| Former Name | LARISSA JANETTE LAKATOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 23519) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD439510) |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2020-12-01 |