| NPI | 1508273533 |
|---|---|
| Former Name | COURTNEY ERIN DESHON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2014006314) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.005074) |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2021-01-29 |