| NPI | 1083704829 |
|---|---|
| Former Name | LYNN LAROCHELLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA 1379) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA PA1379) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 001164) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2015-02-11 |