| NPI | 1740619766 |
|---|---|
| Former Name | SHAVON D. ROBERTSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207820) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 24745) |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2025-03-17 |