Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | 238515 | MA |
NPI | 1124545595 |
---|---|
Provider Name | Yvonne B Gray |
First Address | Kaneohe, HI 96744-4629 |
Second Address | Kaneohe, HI 96744-4629 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2017 |
Last Update Date | 31/10/2021 |