Graduated: 2006
NPI: 1053539031
Practice Locations (2)
LIFESPAN PHYSICIAN GROUP INC
208 COLLYER ST, SUITE 301A
PROVIDENCE, RI 029041560
4017254888
UNIVERSITY SURGICAL ASSOCIATES, INC.
593 EDDY ST
PROVIDENCE, RI 029034923
4014444000
Source: CMS National Downloadable File, September 2026.