| NPI | 1013040666 |
|---|---|
| Former Name | SHANA DALE GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NC 200401063) |
| Additional Taxonomies | 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: NC 2004-01063) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-10-25 |