| NPI | 1316351133 |
|---|---|
| Former Name | DOMINIQUE A GUADALUPE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 338763) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 338763) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2022-07-21 |