Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant |
NPI | 1093167710 |
---|---|
Provider Name | Ms. Ihotu Jennifer Ali |
First Address | New York, NY 10026-3312 |
Second Address | New York, NY 11101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2016 |
Last Update Date | 06/07/2016 |