Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MD2014-0767 | NM |
Y | 111NI0900X | Internist | MD2014-0767 | NM |
NPI | 1003181470 |
---|---|
Provider Name | Dr. Alberto Aguayo Rico |
First Address | Albuquerque, NM 87125-6666 |
Second Address | Albuquerque, NM 87108-2921 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2012 |
Last Update Date | 21/07/2015 |