NPI | 1821356262 |
---|---|
Former Name | ANNE MARIE KRAGOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AK 30-023684) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2012-04-23 |
Last Update Date | 2014-12-03 |