| NPI | 1912364241 |
|---|---|
| Former Name | MAURA ROSE PARNITZKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 00202764) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 1001255-15) |
| Enumeration Date | 2016-01-17 |
| Last Update Date | 2016-06-24 |