Isaac Benjamin Gray Valid NPI

Individual provider · Physician Assistant · Edmond, OK

NPI

1164063699

Type

Individual (Type 1)

Primary specialty

Physician Assistant

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363A00000X

License number

4544 (OK)

Sex

Male

Sole proprietor

Yes

Enumerated

2019-10-06

Last updated

2021-04-12