Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 06-960 | AZ |
NPI | 1043406986 |
---|---|
Provider Name | Dr. Jaime S Ewald |
First Address | Phoenix, AZ 85014-2916 |
Second Address | Phoenix, AZ 85014-2916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2007 |
Last Update Date | 11/08/2021 |