| NPI | 1962542829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL RICHARD MARTIN Vice President 401-738-6565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI 00503) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2020-08-22 |