NPI | 1760863872 |
---|---|
Former Name | CAADRIAN NORMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: OH 30024933) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL DRP1397) |
Enumeration Date | 2015-06-15 |
Last Update Date | 2021-07-01 |