Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 12899 | TN |
NPI | 1366408072 |
---|---|
Provider Name | Dr. Tai June Yoo |
First Address | Memphis, TN 38105-5105 |
Second Address | Memphis, TN 38132-2113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3000214 | (05) | TN |
A96596 | (02) |