| NPI | 1669702569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOHN COBB Owner 401-265-4553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: RI pa00255) |
| Enumeration Date | 2009-12-28 |
| Last Update Date | 2009-12-28 |