| NPI | 1922708015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC DALLAIRE Credentialing Manager 401-323-8755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2023-03-07 |
| Last Update Date | 2023-03-07 |