| NPI | 1013091933 |
|---|---|
| Former Name | MICHELLE LEE LALIBERTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X (Licence: AZ 2364) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 2364) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2024-12-02 |