| NPI | 1316573975 |
|---|---|
| Former Name | OLIVIA LARSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NE 113115) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 113115) |
| Enumeration Date | 2020-03-16 |
| Last Update Date | 2020-12-15 |