| NPI | 1114959814 |
|---|---|
| Former Name | LAURA E FOUQUETTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 9992) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 5338) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2024-02-20 |