| NPI | 1154883486 |
|---|---|
| Professional Name | CHARLIE DOMINGUEZ |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP140823) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 557338) |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2025-03-13 |