Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 4301082592 | MI |
N | 2084N0600X | Clinical Neurophysiologist | 4301082592 | MI |
NPI | 1326216821 |
---|---|
Provider Name | Dr. Aimee F Luat |
First Address | Detroit, MI 48201 |
Second Address | Detroit, MI 48201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2008 |
Last Update Date | 13/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
183872001 | (05) | AR |