NPI | 1285919399 |
---|---|
Former Name | DOROTHY ANN GILBERTSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 014987-1) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006932) |
Enumeration Date | 2011-10-20 |
Last Update Date | 2022-11-15 |