NPI | 1528209293 |
---|---|
Former Name | RUBIE SUE MAYBURY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: MD D77385) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2009-03-10 |
Last Update Date | 2015-02-05 |