Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 942 | AZ |
NPI | 1013103167 |
---|---|
Provider Name | Dr. David Louis Nanni |
First Address | Tucson, AZ 85712-5804 |
Second Address | Tucson, AZ 85712-5804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2007 |
Last Update Date | 17/05/2011 |