NPI | 1356678866 |
---|---|
Former Name | STEPHANIE A MANDUZZI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5601005671) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601005671) |
Enumeration Date | 2009-11-05 |
Last Update Date | 2016-03-09 |