Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 35615 | DC |
Y | 207RP1001X | Pulmonary Disease | 35615 | DC |
NPI | 1083699821 |
---|---|
Provider Name | Robin Gross |
First Address | Boston, MA 02241-8283 |
Second Address | Washington, DC 20007-2113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 07/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G38410 | (02) |