NPI | 1093998015 |
---|---|
Former Name | ROBIN JEANNE BERGQUIST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: OR 60890) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: CA PT 22975) |
2251S0007X Physical Therapist, Sports (Licence: CA PT22975) | |
2251S0007X Physical Therapist, Sports (Licence: OR 60890) | |
Enumeration Date | 2007-12-13 |
Last Update Date | 2016-10-05 |