| NPI | 1154795615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: SC 47-5267829) |
| Additional Taxonomies | 172A00000X Driver (Licence: SC 100295992) |
| 347C00000X Private Vehicle (Licence: SC 100295992) | |
| 251V00000X Voluntary or Charitable (Licence: SC 475267829) | |
| 251S00000X (Licence: SC 475267829) | |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2016-06-23 |