| NPI | 1033632898 |
|---|---|
| Former Name | ALEXANDRA C LARSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MI 1601000791) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: OH A.02103) |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2020-06-08 |