Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 37091 | WI |
NPI | 1003824376 |
---|---|
Provider Name | Mon L Yee |
First Address | Madison, WI 53715-1507 |
Second Address | Deforest, WI 53532-2909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 03/06/2015 |