| NPI | 1114247426 |
|---|---|
| Former Name | JACQUELYN N SEDLOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: VA 0110003305) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003305) |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2023-08-10 |