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 |