| NPI | 1962400069 |
|---|---|
| Former Name | JEANINE MARIE LARSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 615226) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2012-12-04 |