| NPI | 1073964698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174N00000X Lactation Consultant, Non-RN (Licence: UT 11111671) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: UT 1039762) |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2016-06-24 |