Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 50170 | WI |
NPI | 1285757997 |
---|---|
Provider Name | Jesus Igor Iruretagoyena |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53715-1507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 26/10/2017 |