| NPI | 1063724664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: IL 036130751) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125058535) |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2021-12-28 |