| NPI | 1255341970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: IL 036132041) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: MD 0050656) |
| 208C00000X Colon & Rectal Surgery (Licence: DC 17999) | |
| 208C00000X Colon & Rectal Surgery (Licence: FL ME134093) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2024-03-05 |