| NPI | 1689835019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASAM H SOHI Resident 423-266-1813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2008-06-18 |