| NPI | 1306615729 |
|---|---|
| Former Name | ANTIONETTE RUBY COATES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172A00000X Driver (Licence: MN M10311302104) |
| Additional Taxonomies | 172A00000X Driver (Licence: MN M103113024104) |
| Enumeration Date | 2023-12-27 |
| Last Update Date | 2023-12-27 |