Individual
DR. LISA G. DISTEFANO
Active
Individual
DR. LISA G. DISTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0450138
KS
207R00000X
Internal Medicine Physician
119536
MO
208000000X
Pediatrics Physician
119536
MO
Other
Enumeration date
06/09/2005
Last updated
11/12/2024
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