| NPI | 1538422118 |
|---|---|
| Other Name | KENNY LARSEN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA2016) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003922) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2019-12-31 |