Graduated: 1995
Also: INTERNAL MEDICINE
NPI: 1700804192
Practice Locations (2)
STATE OF RHODE ISLAND
111 HOWARD AVE
CRANSTON, RI 029203001
4014623666
LIFESPAN PHYSICIAN GROUP INC
593 EDDY ST
PROVIDENCE, RI 029034923
4014444000
Source: CMS National Downloadable File, September 2026.