| NPI | 1356906846 |
|---|---|
| Former Name | JENNIFER ANKLAN LARSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12091) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 14574-24) |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2024-07-03 |