NPI | 1093207037 |
---|---|
Former Name | LINDSAY LARABEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 4201) |
Additional Taxonomies | 363A00000X Physician Assistant |
363AM0700X Physician Assistant, Medical (Licence: CT 4201) | |
Enumeration Date | 2018-06-05 |
Last Update Date | 2022-02-23 |