| NPI | 1699873901 |
|---|---|
| Former Name | STEPHANIE M. DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA052769) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2024-04-08 |