NPI | 1831463231 |
---|---|
Former Name | KATHLEEN ELIZABETH LIEBERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085004295) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA07666) |
Enumeration Date | 2012-03-02 |
Last Update Date | 2024-01-03 |