| NPI | 1336671593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: IA MD-51537) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: IL 036.165921) |
| 208C00000X Colon & Rectal Surgery (Licence: MO 2026013958) | |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2026-06-02 |