Medical school: SOUTHERN COLLEGE OF OPTOMETRY
Graduated: 1989
NPI: 1700873692
Practice Locations (2)
6721 LAKE HARBOUR DR
MIDLOTHIAN, VA 231122083
8047394000
BLUESTEM FARMS LLC
6721 LAKE HARBOUR DR
MIDLOTHIAN, VA 231122083
8047394000
Source: CMS National Downloadable File, September 2026.