Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | L-86786 |
NPI | 1275293128 |
---|---|
Provider Name | Ismarie Raldiris |
First Address | Caguas, PR 00727-3412 |
Second Address | Caguas, PR 00727-3412 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2021 |
Last Update Date | 20/12/2021 |