| NPI | 1629509641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MASON GASPER Owner 401-378-0258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI 00611) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2019-11-14 |