Graduated: 2016
NPI: 1346692779
Practice Locations (2)
THE MIRIAM HOSPITAL
208 COLLYER ST, SUITE 100
PROVIDENCE, RI 029041560
4017937191
LIFESPAN PHYSICIAN GROUP INC
593 EDDY ST
PROVIDENCE, RI 029034923
4014444000
Source: CMS National Downloadable File, September 2026.