| NPI | 1295055077 |
|---|---|
| Former Name | SHEA ELIZABETH FETHERSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0003935) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0003935) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2024-02-05 |