| NPI | 1952478273 |
|---|---|
| Former Name | ROBERTA AUGUST SHIELDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 1172) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 9280) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2007-07-16 |