| NPI | 1790187896 |
|---|---|
| Former Name | TAYLOR LARSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 12882) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2017-07-14 |