Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1063906105 |
---|---|
Provider Name | Jamie Tomilo |
First Address | Buffalo, NY 14220-1615 |
Second Address | Amherst, NY 14226-4567 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2018 |
Last Update Date | 21/06/2018 |