| NPI | 1659596450 |
|---|---|
| Former Name | KIMBERLY A OTTO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: TX 617471) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2016-03-09 |