Graduated: 2010
NPI: 1679821862
Practice Locations (2)
LIFESPAN PHYSICIAN GROUP INC
593 EDDY ST
PROVIDENCE, RI 029034923
4012721800
UNIVERSITY SURGICAL ASSOCIATES, INC.
593 EDDY ST
PROVIDENCE, RI 029034923
4014444000
Source: CMS National Downloadable File, September 2026.