| NPI | 1235562083 |
|---|---|
| Former Name | MICHELLE CALPE LARSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6449) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: AZ 0538) |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2016-09-15 |