Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 202101212 | NC |
NPI | 1003313818 |
---|---|
Provider Name | Sarah Haley Gross |
First Address | Durham, NC 27703-6614 |
Second Address | Wake Forest, NC 27587-5745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2018 |
Last Update Date | 18/08/2021 |