| NPI | 1992211312 |
|---|---|
| Former Name | STACIA PETTUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: TX 80928) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: NY 14000052000) |
| Enumeration Date | 2017-12-21 |
| Last Update Date | 2024-02-20 |