| NPI | 1407454564 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H5809)  | 
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WA HL60545314)  | 
| Enumeration Date | 2020-10-12 | 
| Last Update Date | 2025-06-13 |