| NPI | 1841533171 |
|---|---|
| Former Name | KAMI JO LARSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.142057) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60587321) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: IL 036.142057) | |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2024-01-08 |