| NPI | 1154559763 |
|---|---|
| Former Name | MELISSA MARIE LARSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 53193) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 21942) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2013-10-18 |