Medical school: JS WEILL MEDICAL COLLEGE, CORNELL UNIVERSITY
Graduated: 1990
NPI: 1972570182
Practice Locations (2)
LIFESPAN PHYSICIAN GROUP INC
164 SUMMIT AVE, C70
PROVIDENCE, RI 029062853
4017934545
UNIVERSITY SURGICAL ASSOCIATES, INC.
2 DUDLEY ST
PROVIDENCE, RI 029053248
4012721800
Source: CMS National Downloadable File, September 2026.