Graduated: 2024
NPI: 1790667350
Practice Locations (2)
LIFESPAN PHYSICIAN GROUP INC
208 COLLYER ST, SUITE 301A
PROVIDENCE, RI 029041560
4017254888
UNIVERSITY SURGICAL ASSOCIATES, INC.
208 COLLYER ST, SUITE 301A
PROVIDENCE, RI 029041560
4012721800
Source: CMS National Downloadable File, September 2026.