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Individual
BENJAMIN ZACHARY LARSEN
Active
Individual
BENJAMIN ZACHARY LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11401709-1205
UT
208D00000X
General Practice Physician
Primary
11401709-1205
UT
Other
Enumeration date
05/21/2018
Last updated
06/02/2021
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