| NPI | 1699183061 |
|---|---|
| Former Name | JENNIFER LARIE DOVICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 60918984) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2808) |
| 152W00000X Optometrist (Licence: CA 15365TLG) | |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2019-02-11 |