| NPI | 1740609981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAROLD J WANEBO Owner 401-529-2828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: RI MD07200) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2015-03-26 |