| NPI | 1659374122 |
|---|---|
| Other Name | LANE PHILLIPS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 0S7692) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 83416) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2021-07-12 |