| NPI | 1730467325 |
|---|---|
| Former Name | SHANA CAMILLE KIRBY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME119309) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301098952) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME 119309) | |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2018-01-05 |