| NPI | 1689970279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MD D0076299) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036.126088) |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2016-10-22 |