Individual
BRADLEY LARSON
Active
Individual
BRADLEY LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301110680
MI
207L00000X
Anesthesiology Physician
Primary
4301505299
MI
207LP3000X
Pediatric Anesthesiology Physician
4301505299
MI
Other
Enumeration date
07/18/2016
Last updated
11/01/2023
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