| NPI | 1225698558 |
|---|---|
| Other Name | JACKIE MOSTOW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A180243) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.149134) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2023-08-24 |