| NPI | 1699844225 |
|---|---|
| Former Name | GREGORY E. LARSON SAWIN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2019-02755) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 232606) |
| 207Q00000X Family Medicine (Licence: VA 0101238112) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-01-15 |