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Individual
AMY BETH DETTORI
Active
Individual
AMY BETH DETTORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
MD61153930
WA
2083A0100X
Aerospace Medicine Physician
01068606A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/26/2009
Last updated
06/10/2021
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