NPI | 1154875797 |
---|---|
Former Name | CORI ARENA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3010377) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010377) |
Enumeration Date | 2016-08-11 |
Last Update Date | 2023-12-07 |