NPI | 1104472513 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: FL DO6738) |
Additional Taxonomies | 174H00000X Health Educator |
174N00000X Lactation Consultant, Non-RN | |
Enumeration Date | 2019-08-12 |
Last Update Date | 2019-08-12 |