MACKENZIE MAE LARSEN

STANFORD, CA
NPI1922560002
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: CA  PA58481)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2019-04-05
Last Update Date2020-12-04
Business Address
MACKENZIE MAE LARSEN
STANFORD UNIVERSITY SCHOOL OF MEDICINE 291 CAMPUS DRIVE
STANFORD, CA 94305
Phone number: 919-604-2810
Mailing Address
MACKENZIE MAE LARSEN
1 VISTA VERDE WAY
PORTOLA VALLEY, CA 94028-8142
Phone number: 919-604-2810