Medical school: RUTGERS NEW JERSEY MEDICAL SCHOOL
Graduated: 1986
NPI: 1023009404
Practice Locations (2)
LIFESPAN PHYSICIAN GROUP INC
1 HOPPIN ST, SUITE 202
PROVIDENCE, RI 029034141
4014446551
1 THURBER BLVD, UNIT B
SMITHFIELD, RI 029171826
4013495360
Source: CMS National Downloadable File, September 2026.