Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | SP210 | IA |
N | 111NI0900X | Internist | SP210 | IA |
N | 207RH0003X | Hematology & Oncology | 6630705 | UT |
Y | 207RH0003X | Hematology & Oncology | SP210 | IA |
N | 207RX0202X | Medical Oncology | SP210 | IA |
NPI | 1063502540 |
---|---|
Provider Name | Guido Tricot |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 08/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
123143001 | (05) | AR |
E45861 | (02) |