| NPI | 1902037914 |
|---|---|
| Former Name | MICHELE DIANE LAREAU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055-0031070) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VT 005-0030983) |
| Enumeration Date | 2009-08-07 |
| Last Update Date | 2011-10-11 |