Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 125.067488 | IL |
N | 111NI0900X | Internist | 125.067488 | IL |
Y | 207R00000X | Internist | MD-47467 | IA |
Y | 111NI0900X | Internist | MD-47467 | IA |
N | 207RA0201X | Internist - Allergy & Immunology | MD-47467 | IA |
N | 208000000X | Pediatrician | 125.067488 | IL |
N | 208000000X | Pediatrician | MD-47467 | IA |
N | 2080P0201X | Pediatric Allergist | MD-47467 | IA |
NPI | 1417332016 |
---|---|
Provider Name | Lilian Del Carmen Gonzalez |
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 | 23/07/2015 |
Last Update Date | 08/07/2020 |