Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 51556 | MN |
N | 207VX0000X | Obstetrician | 51556 | MN |
NPI | 1316073448 |
---|---|
Provider Name | Marijo Nicole Aguilera |
First Address | Minneapolis, MN 55425-4516 |
Second Address | Saint Paul, MN 55107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2007 |
Last Update Date | 25/07/2019 |