Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | RS20070360 | NM |
Y | 2080P0203X | Pediatric Critical Care Doctor | MD2010-0132 | NM |
NPI | 1063533669 |
---|---|
Provider Name | Janelle Mares Aragon |
First Address | Albuquerque, NM 87123-5747 |
Second Address | Albuquerque, NM 87131-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 28/03/2012 |