| NPI | 1902365869 |
|---|---|
| Doing Business As | AUTUMN WAKE, RN, BSN, IBCLC |
| Entity Type | Organization |
| Authorized Contact | AUTUMN WAKE Owner/Practitioner 702-764-9290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WL0100X Registered Nurse, Lactation Consultant |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2019-03-20 |