| NPI | 1477821130 |
|---|---|
| Former Name | BROOKE VANESSA PERDOMO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 164786) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106366) |
| Enumeration Date | 2011-12-09 |
| Last Update Date | 2021-07-02 |