Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 1002076 | WI |
NPI | 1003476706 |
---|---|
Provider Name | Dr. Aubrey Lukas |
First Address | Mount Pleasant, WI 53405-4662 |
Second Address | Mount Pleasant, WI 53405-4662 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2019 |
Last Update Date | 16/06/2019 |