| NPI | 1780845511 |
|---|---|
| Former Name | NICOLE ALEXANDRA VAZQUEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: IL 019.027690) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.027690) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2025-05-29 |