Graduated: 2021
NPI: 1649862863
Practice Locations (2)
LIFESPAN PHYSICIAN GROUP INC
19 FRIENDSHIP ST, UNIT 320
NEWPORT, RI 028402200
4018451910
THE MIRIAM HOSPITAL
164 SUMMIT AVE
PROVIDENCE, RI 029062894
4017938700
Source: CMS National Downloadable File, September 2026.