| NPI | 1366957631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN VILLAS DELA LUNA Member 401-333-3810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD14529) |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2017-12-08 |