| NPI | 1003269747 |
|---|---|
| Former Name | ANGIE MARIE BLASE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: NE 978) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |