| NPI | 1952460933 |
|---|---|
| Former Name | LARISSA CHISM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01065230A) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036163626) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2024-09-20 |