Medical school: TUFTS UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1967
NPI: 1386649523
Practice Locations (1)
PROSPECT CHARTERCARE SJHSRI LLC
200 HIGH SERVICE AVE, FATIMA HOSPITAL WOUND CARE GROUP
N PROVIDENCE, RI 029045113
4014563011
Source: CMS National Downloadable File, September 2026.