| NPI | 1922515576 |
|---|---|
| Former Name | MALLORY ELISE LIGHTFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 850960) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 850960) |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2023-03-24 |