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Individual
LARISA GALLO
Active
Individual
LARISA GALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA15748
TX
363A00000X
Physician Assistant
PA52481
CA
363AM0700X
Medical Physician Assistant
MA056002
PA
Other
Enumeration date
02/14/2013
Last updated
06/09/2022
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