| NPI | 1699282020 |
|---|---|
| Former Name | DOMINIQUE CARLOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA1929) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: IN 10004488A) |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2024-08-12 |