Individual
LAURA S GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036.145736
IL
207L00000X
Anesthesiology Physician
Primary
65091
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487072492
—
WI
Enumeration date
04/07/2014
Last updated
07/23/2019
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