| NPI | 1013445329 |
|---|---|
| Former Name | JUSTIN LANIER SANDERS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM 082019) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL 15602) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2020-09-10 |