NPI | 1750820965 |
---|---|
Former Name | MARIKO ELIZABETH LIGHTNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95006095) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95053145) |
Enumeration Date | 2017-02-21 |
Last Update Date | 2022-04-06 |