| 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 |