Graduated: 2015
NPI: 1992166813
Practice Locations (2)
THE MIRIAM HOSPITAL
164 SUMMIT AVE
PROVIDENCE, RI 029062853
4017937245
THE MIRIAM HOSPITAL
180 CORLISS ST, SUITE C
PROVIDENCE, RI 029042602
4017934636
Source: CMS National Downloadable File, September 2026.