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 |