| NPI | 1144876343 |
|---|---|
| Former Name | JOCELYN SARAH STOUDT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA OA004940) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060914) |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2021-07-20 |