| NPI | 1194365510 |
|---|---|
| Former Name | MICHELLE JAN MOSTOWY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061204) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005116) |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2024-10-23 |