Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | 25172 | NE |
NPI | 1003042912 |
---|---|
Provider Name | Dr. Minhtriet H Luu |
First Address | Lincoln, NE 68506-4675 |
Second Address | Lincoln, NE 68506-4675 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2009 |
Last Update Date | 05/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
25172 | NEBRASKA MEDICAL LICENSE (01) | NE |