Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-305949 | CA |
NPI | 1063025898 |
---|---|
Provider Name | Judy Sm Li |
First Address | Arcadia, CA 91006-5601 |
Second Address | Arcadia, CA 91006-5601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2020 |
Last Update Date | 16/12/2021 |