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 |