| NPI | 1104034172 |
|---|---|
| Former Name | VIRGINIA CHRISTINA GARNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 5440) |
| Additional Taxonomies | 122300000X Dentist (Licence: MS 3362-05) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2009-11-02 |