| NPI | 1083038376 |
|---|---|
| Former Name | DYLAN THORNE-FITZGERALD |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT026972) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0003395) |
| 225100000X Physical Therapist (Licence: MD 24880) | |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2020-08-10 |