| NPI | 1972229904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172A00000X Driver (Licence: OH TP262911) |
| Additional Taxonomies | 171W00000X Contractor (Licence: OH TP262911) |
| Enumeration Date | 2022-10-12 |
| Last Update Date | 2022-10-12 |