| NPI | 1992997787 |
|---|---|
| Former Name | CHRISTINA LORRAINE DOMINO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05948) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: WI 2186) | |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2011-11-30 |