Individual
CONNOR LAROSE
Active
Individual
CONNOR LAROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
A111430
CA
390200000X
Student in an Organized Health Care Education/Training Program
AD3189380-CL19
NC
Other
Enumeration date
05/20/2008
Last updated
03/14/2012
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