| NPI | 1477726875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036132532) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 232554) |
| 208C00000X Colon & Rectal Surgery (Licence: IL 036.132532) | |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2021-10-18 |