| NPI | 1649665118 |
|---|---|
| Former Name | ELIZABETH EWIG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MO 2018011002) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085005440) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2019-03-07 |