NPI | 1871848754 |
---|---|
Former Name | ERICA RICHARDSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 11361) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 39108) |
Enumeration Date | 2012-07-17 |
Last Update Date | 2020-10-12 |