| NPI | 1598750507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: IL 036114423) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: IA 36284) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2012-05-11 |