Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1326406976 |
---|---|
Provider Name | Lily Martinez |
First Address | Paramount, CA 90723-3738 |
Second Address | Paramount, CA 90723-3738 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2016 |
Last Update Date | 10/02/2016 |