| NPI | 1538435268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: GA 83795) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 83795) |
| 208600000X Surgery (Licence: IL 036137178) | |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2024-01-09 |