| NPI | 1659568921 |
|---|---|
| Former Name | WANDA E VILLAMIL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN ds5418) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN ds5418) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2007-10-01 |