| NPI | 1770345589 |
|---|---|
| Former Name | LICET CAROLINA MUNOZ VASQUEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401420081) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2024-01-26 |
| Last Update Date | 2026-07-24 |