Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 36719 | NC |
N | 2080A0000X | Adolescent Medicine | 36719 | NC |
NPI | 1184619959 |
---|---|
Provider Name | Dr. Sarah Rona Grossman |
First Address | Gastonia, NC 28054-4839 |
Second Address | Gastonia, NC 28054-4839 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2005 |
Last Update Date | 09/09/2011 |