| NPI | 1841683562 |
|---|---|
| Former Name | MALLORY M MOSKO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1992) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 004112) |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2018-09-14 |