| NPI | 1649217613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: IL 036082092) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2004016430) |
| 208C00000X Colon & Rectal Surgery (Licence: MO 2004016430) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2015-03-25 |