Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 2154I | AZ |
NPI | 1033563002 |
---|---|
Provider Name | Vittoria Giovannucci |
First Address | Sun City, AZ 85351-2719 |
Second Address | Sun City, AZ 85351 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2016 |
Last Update Date | 19/12/2018 |