NPI | 1942202494 |
---|---|
Former Name | SHIRLEY R TREDEAU |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704245825) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704245825) |
Enumeration Date | 2005-08-15 |
Last Update Date | 2008-10-06 |