| NPI | 1134641996 |
|---|---|
| Former Name | STEPHANIE POULOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: IN 23002628A) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: IN 23002628A) |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2023-11-27 |