| NPI | 1609563188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172A00000X Driver (Licence: OH RT809581) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: OH RT809581) |
| Enumeration Date | 2023-04-24 |
| Last Update Date | 2023-04-24 |