Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 123308 | AK |
NPI | 1003346727 |
---|---|
Provider Name | Dr. Huanan Li |
First Address | Anchorage, AK 99518-1251 |
Second Address | Anchorage, AK 99501-3739 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2017 |
Last Update Date | 14/06/2017 |