Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 11167483 | NY |
NPI | 1033484977 |
---|---|
Provider Name | Dikla Z Barak |
First Address | Brooklyn, NY 11217-2155 |
Second Address | Brooklyn, NY 11217-2155 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2012 |
Last Update Date | 10/03/2012 |