| NPI | 1568468619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036064410) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: IL 036064410) |
| 208C00000X Colon & Rectal Surgery (Licence: IL 036064410) | |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2007-12-17 |