| NPI | 1023797826 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MATTHEW ROCHELEAU Owner 401-373-0820 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care | 
| Additional Taxonomies | 207R00000X Internal Medicine | 
| Enumeration Date | 2023-07-18 | 
| Last Update Date | 2024-01-22 |