| NPI | 1811044209 |
|---|---|
| Former Name | EILEEN SHANNON HUBBARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11470) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA002587L) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2022-12-01 |