| NPI | 1427076694 |
|---|---|
| Former Name | MARY BETH LARCOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251H1200X Physical Therapist, Hand (Licence: MN 100697) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MN 100697) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-07-08 |