NPI | 1174974661 |
---|---|
Other Name | GLADYS LARSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 277001014) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 277.001014) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277001014) | |
Enumeration Date | 2016-06-26 |
Last Update Date | 2025-01-31 |