| NPI | 1639601172 | 
|---|---|
| Former Name | LAUREL ANNE WHITIS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC D0210001343) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A18030) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-03 | 
| Last Update Date | 2022-08-25 |