Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | R4776 | TX |
Y | 207XX0801X | Orthopaedic Trauma Surgeon | A-174126 | CA |
NPI | 1003254269 |
---|---|
Provider Name | Michelle Marie Gosselin |
First Address | Pensacola, FL 32508-1044 |
Second Address | Pensacola, FL 32508-1044 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2013 |
Last Update Date | 08/09/2021 |