Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1326790767 |
---|---|
Provider Name | Margaret Moore |
First Address | Ithaca, NY 14850-4318 |
Second Address | Ithaca, NY 14850-4318 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2022 |
Last Update Date | 26/01/2022 |