Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-302511 | CA |
NPI | 1114514122 |
---|---|
Provider Name | Mrs. Alexandra Rose Low |
First Address | San Jose, CA 95125-3231 |
Second Address | San Jose, CA 95125-3231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2020 |
Last Update Date | 23/12/2020 |