| NPI | 1508026832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CA A135013) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A135013) |
| 208600000X Surgery (Licence: IL 036114508) | |
| 208600000X Surgery (Licence: NY 259161) | |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2020-11-17 |