NPI | 1619980745 |
---|---|
Former Name | VIKKI LOUISE VAUGHN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: MA 19519) |
Enumeration Date | 2006-08-13 |
Last Update Date | 2009-09-24 |