NPI | 1386933802 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 174N00000X Lactation Consultant, Non-RN (Licence: OR L-64562) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 14790) |
Enumeration Date | 2011-04-05 |
Last Update Date | 2015-05-14 |