Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 4917 | NV |
NPI | 1164561734 |
---|---|
Provider Name | Dr. Trudy Larson |
First Address | Reno, NV 89503-4407 |
Second Address | Reno, NV 89503-4407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 08/07/2007 |