| NPI | 1922641521 |
|---|---|
| Former Name | STEPHANIE RAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061879) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-10-26 |
| Last Update Date | 2023-10-23 |