Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 111455 | MO |
NPI | 1033322318 |
---|---|
Provider Name | Lisa D. Monsees |
First Address | Columbia, MO 65201-6625 |
Second Address | Columbia, MO 65201-6625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 08/07/2007 |