NPI | 1083171540 |
---|---|
Former Name | JESSICA ANN BENJOU |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WL0100X Registered Nurse, Lactation Consultant (Licence: NY L-136972) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 617847-1) |
Enumeration Date | 2019-02-20 |
Last Update Date | 2019-02-20 |