Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 35.139240 | OH |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 35.139240 | OH |
NPI | 1487008751 |
---|---|
Provider Name | Kiyanna Marie Williams |
First Address | Ann Arbor, MI 48103-2055 |
Second Address | Cleveland, OH 44195-1014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2016 |
Last Update Date | 02/10/2020 |