Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | MD-41685 | IA |
N | 207VX0201X | Gynecologic Oncologist | 45223 | MN |
Y | 207VX0201X | Gynecologic Oncologist | MD-41685 | IA |
NPI | 1427023175 |
---|---|
Provider Name | Jesus Gonzalez Bosquet |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2006 |
Last Update Date | 21/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
368632900 | (05) | MN |
H74348 | (02) |