Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 60616 | MN |
N | 207RH0003X | Hematology & Oncology | 60616 | MN |
Y | 207RX0202X | Medical Oncology | 60616 | MN |
NPI | 1265872196 |
---|---|
Provider Name | Mr. Jesus Vera Aguilera |
First Address | Duluth, MN 55805-1951 |
Second Address | Duluth, MN 55805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2013 |
Last Update Date | 11/06/2019 |