| NPI | 1235660663 |
|---|---|
| Former Name | IDA MAYLYNN MAYS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MT MED-PHYS-LIC-126760) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD61288990) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MT MED-PHYS-LIC-126760) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2086S0127X Surgery, Trauma Surgery (Licence: MT MED-PHYS-LIC-126760) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2024-02-19 |