| NPI | 1538744362 |
|---|---|
| Former Name | CARLITA LEIGH DOMINGUEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NH 112310-23) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11019350) |
| 363L00000X Nurse Practitioner (Licence: MA RN2309117) | |
| Enumeration Date | 2021-03-12 |
| Last Update Date | 2024-09-11 |