| NPI | 1538763156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA T POLHEMUS Controller 401-788-1974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology Neuromuscular Medicine |
| Enumeration Date | 2020-11-24 |
| Last Update Date | 2020-11-24 |