Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist |
NPI | 1053602433 |
---|---|
Provider Name | Angela L. Kiyaani |
First Address | Tuba City, AZ 86045-0600 |
Second Address | Tuba City, AZ 86045-0600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2011 |
Last Update Date | 20/04/2011 |