| NPI | 1881174936 |
|---|---|
| Former Name | JACLYN M. SUDOL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: SC 22048) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 22048) |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2024-01-03 |