| NPI | 1053320671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: IL 036.133002) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: MN 45364) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2016-07-08 |