NPI | 1821006396 |
---|---|
Former Name | YEVGENY MANDELBROYT |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213E00000X Podiatrist (Licence: IL 016-004841) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: WI 751-025) |
213E00000X Podiatrist (Licence: OH 36-003405) | |
213E00000X Podiatrist (Licence: MO 2002002944) | |
213E00000X Podiatrist (Licence: IN 07000848A) | |
213E00000X Podiatrist (Licence: MN 685) | |
213E00000X Podiatrist (Licence: MI 5901002069) | |
Enumeration Date | 2006-08-03 |
Last Update Date | 2012-08-10 |