| NPI | 1952710923 |
|---|---|
| Former Name | KRISTA LARSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 9053209-1206) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 9053209-8906) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2025-11-19 |