| NPI | 1497248520 |
|---|---|
| Former Name | DOMINIQUE NICOLE FORTUNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA ap09895) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA RN299261) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: GA RN299261) | |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2024-02-19 |