| NPI | 1568779080 |
|---|---|
| Former Name | GRACIELA VIGIL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 0026126) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 59698) |
| Enumeration Date | 2010-09-03 |
| Last Update Date | 2017-01-06 |