| NPI | 1144622747 |
|---|---|
| Former Name | JELENA VUCIJAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1857836) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 30215) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2018-04-04 |