| NPI | 1649472580 |
|---|---|
| Former Name | RITA ANN BRUST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 74757) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5101017141) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2021-03-25 |