| NPI | 1104188127 |
|---|---|
| Former Name | ELIZABETH COURTNEY FEGELY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 22306) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 22306) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2020-01-16 |