Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 4301091929 | MI |
N | 208000000X | Pediatrician | 4301091929 | MI |
NPI | 1164682894 |
---|---|
Provider Name | Aimee Leyton Speck |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48105-9484 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2008 |
Last Update Date | 19/12/2018 |