| NPI | 1457124281 |
|---|---|
| Former Name | NOELLE CHRISTINE LARSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 14331-33) |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2023-11-02 |