NPI | 1285660860 |
---|---|
Former Name | KAREN LARSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 000912) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 163873) |
Enumeration Date | 2006-06-24 |
Last Update Date | 2010-02-22 |