Individual
ERICA DOMINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 643-4535
Mailing address
20 GUYENCOURT RD, WILMINGTON, DE 19807-1416
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN2289966
MA
Other
Enumeration date
01/18/2014
Last updated
01/18/2014
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