| NPI | 1609164391 |
|---|---|
| Other Name | DAVE MICHAEL LARSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CA A122666) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A122666) |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2019-09-01 |