| NPI | 1588688477 |
|---|---|
| Former Name | HEATHER NICOLE DOMINGUEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA 330868) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NM 2015-0823) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2022-07-21 |