Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 45759 | AZ |
Y | 207P00000X | Emergency Physician | MD60325597 | WA |
N | 207P00000X | Emergency Physician | R71684 | AZ |
NPI | 1013146653 |
---|---|
Provider Name | Austin M Gross |
First Address | Kirkland, WA 98034-3013 |
Second Address | Kirkland, WA 98034-3013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2009 |
Last Update Date | 09/06/2013 |