| NPI | 1790467421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: OK K000078786) |
| Additional Taxonomies | 172A00000X Driver (Licence: OK K000078786) |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: OK K000078786) | |
| 347C00000X Private Vehicle (Licence: OK K000078786) | |
| Enumeration Date | 2023-08-02 |
| Last Update Date | 2023-08-02 |