| NPI | 1053997254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174N00000X Lactation Consultant, Non-RN (Licence: OR LC-LC-10214114) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 26277) |
| Enumeration Date | 2021-03-19 |
| Last Update Date | 2022-05-17 |