Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 4351044549 | MI |
NPI | 1003473851 |
---|---|
Provider Name | Taylor Adlam |
First Address | Dearborn, MI 48124-4085 |
Second Address | Dearborn, MI 48124-4085 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2019 |
Last Update Date | 28/06/2020 |