| NPI | 1205930484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: IL 036.156541) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: PA MD434006) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2021-05-20 |