NPI | 1104142470 |
---|---|
Former Name | ELIZAVETA V ROGOL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: ME DEN5249) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: ME MD29441) |
204E00000X Oral & Maxillofacial Surgery (Licence: NM DD4981) | |
Enumeration Date | 2010-04-12 |
Last Update Date | 2025-09-05 |