Graduated: 1978
NPI: 1528016391
Practice Locations (2)
LIFESPAN PHYSICIAN GROUP INC
593 EDDY ST
PROVIDENCE, RI 029034923
4014444000
RHODE ISLAND HOSPITAL
593 EDDY ST
PROVIDENCE, RI 029034923
4016061004
Source: CMS National Downloadable File, September 2026.