| NPI | 1104494095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 347E00000X Transportation Broker |
| 347C00000X Private Vehicle (Licence: NC ffm6309) | |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2024-05-14 |