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 |