Individual
DYLAN IRISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
1149199
AZ
363A00000X
Physician Assistant
Primary
7467
AZ
Other
Enumeration date
05/16/2019
Last updated
01/14/2021
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