| NPI | 1861193930 |
|---|---|
| Former Name | LARISSA K YOUNG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 10188) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2330422) |
| Enumeration Date | 2023-03-15 |
| Last Update Date | 2023-06-14 |