| NPI | 1174939649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: IL 036-149800) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036-149800) |
| 208C00000X Colon & Rectal Surgery (Licence: AZ 61609) | |
| 208600000X Surgery (Licence: MA 260643) | |
| Enumeration Date | 2014-07-06 |
| Last Update Date | 2022-07-12 |