NPI | 1346237864 |
---|---|
Former Name | LARA INGA VANDERYACHT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NE 5846) |
Enumeration Date | 2005-09-30 |
Last Update Date | 2011-08-12 |