| NPI | 1265800742 |
|---|---|
| Former Name | LAURA MARIE HILDEBRANDT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1434) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61022472) |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2022-04-21 |