| NPI | 1710319744 |
|---|---|
| Former Name | LULU FANG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA RES-30544) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 29211) |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2019-07-05 |