| NPI | 1558411223 |
|---|---|
| Former Name | IDA MARILOU BUTALIO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP1512312) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ARNP1512312) |
| 363LF0000X Nurse Practitioner Family (Licence: FL ARNP 1512312) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2021-08-17 |