| NPI | 1508408170 |
|---|---|
| Former Name | ASHLEY LARSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0001377) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0007336) |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2020-01-09 |