Individual
MATTHEW ERICK LARSON
Active
Individual
MATTHEW ERICK LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207UN0902X
Nuclear Imaging & Therapy Physician
Primary
73825-20
WI
2085R0202X
Diagnostic Radiology Physician
73825-20
WI
Other
Enumeration date
04/12/2018
Last updated
12/12/2024
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