Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD-44694 | IA |
N | 111NI0900X | Internist | MD-44694 | IA |
N | 207RN0300X | Nephrologist | 47036 | CO |
Y | 207RN0300X | Nephrologist | MD-44694 | IA |
NPI | 1033142096 |
---|---|
Provider Name | Diana I. Jalal |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
65485866 | (05) | CO |