| NPI | 1487065439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172A00000X Driver |
| Additional Taxonomies | 171W00000X Contractor |
| 171W00000X Contractor (Licence: TX 101000100) | |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2014-05-13 |