| NPI | 1144700782 |
|---|---|
| Professional Name | BRADLEY DAVID LARSEN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 1161415) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 1161415) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2022-08-17 |