| NPI | 1154965903 |
|---|---|
| Former Name | HEIDI L DOMINIAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NY 404965) |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2023-11-22 |