| NPI | 1942291604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: IL 03149083) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: MA 225056) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2019-06-06 |