| NPI | 1861981037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: IL 125081492) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301512390) |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2024-09-11 |