| NPI | 1215277991 |
|---|---|
| Former Name | ANDREA ELIZABETH ERICKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SD 1193) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 004409) |
| Enumeration Date | 2013-02-18 |
| Last Update Date | 2016-12-13 |