| NPI | 1134507791 |
|---|---|
| Former Name | JESSICA BARNUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 300473) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT.015280) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2021-12-22 |