| NPI | 1558715458 |
|---|---|
| Former Name | CAITLIN DACEY JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35.141841) |
| Enumeration Date | 2016-04-17 |
| Last Update Date | 2022-01-25 |