| NPI | 1629935713 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172A00000X Driver (Licence: OH ul990106) |
| Additional Taxonomies | 347C00000X Private Vehicle (Licence: OH ul990106) |
| Enumeration Date | 2026-01-08 |
| Last Update Date | 2026-02-04 |