Graduated: 1993
NPI: 1881613057
Practice Locations (2)
RHODE ISLAND HOSPITAL
146 W RIVER ST, SUITE 11A
PROVIDENCE, RI 029042609
4016068250
LIFESPAN PHYSICIAN GROUP INC
164 SUMMIT AVE
PROVIDENCE, RI 029062853
4017934102
Source: CMS National Downloadable File, September 2026.