| NPI | 1144473802 |
|---|---|
| Former Name | ALEXIS DANIELLE CHARLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA opt002562) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001742) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2011-03-09 |