Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-303362 |
NPI | 1174291116 |
---|---|
Provider Name | Sarah Gruman |
First Address | Los Angeles, CA 90036-3144 |
Second Address | Los Angeles, CA 90036-3144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2021 |
Last Update Date | 03/09/2021 |