| NPI | 1609161694 |
|---|---|
| Former Name | ANNA PERDOMO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 002903) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP0024980) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2018-11-14 |