Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 3538 | MO |
NPI | 1346431277 |
---|---|
Provider Name | Dr. Nadim Toufic Nasrallah |
First Address | Creve Coeur, MO 63141-7143 |
Second Address | Creve Coeur, MO 63141-7143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2007 |
Last Update Date | 06/08/2007 |