| NPI | 1154845048 |
|---|---|
| Former Name | LESLIE GATEWOOD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174N00000X Lactation Consultant, Non-RN (Licence: Alpp-254322) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: 67018105a) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2022-07-21 |