Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 17067 | NH |
N | 207P00000X | Emergency Physician | MT201519 | PA |
NPI | 1013271998 |
---|---|
Provider Name | Zea Larochelle |
First Address | Concord, NH 03301-7539 |
Second Address | Concord, NH 03301-7539 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2012 |
Last Update Date | 15/06/2015 |