Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 11178 | MT |
Y | 2080P0214X | Pediatric Pulmonologist | 51166 | MN |
NPI | 1265531768 |
---|---|
Provider Name | Theresa A. Laguna |
First Address | Minneapolis, MN 55455-0341 |
Second Address | Minneapolis, MN 55454-1404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 02/03/2016 |