| NPI | 1902009715 |
|---|---|
| Former Name | STACI M LARSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MT MED-PHYS-LIC-56187) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 50895) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: WY TL3906) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: NM MD2014-0792) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 50895) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2022-03-08 |