Graduated: 2020
NPI: 1649899337
Practice Locations (2)
LIFESPAN PHYSICIAN GROUP INC
195 COLLYER ST, SUITE 302
PROVIDENCE, RI 029041869
4012721800
UNIVERSITY SURGICAL ASSOCIATES, INC.
195 COLLYER ST, SUITE 302
PROVIDENCE, RI 029041869
4017935140
Source: CMS National Downloadable File, September 2026.