| NPI | 1639341795 | 
|---|---|
| Former Name | GENEVIE LOREE SHARP | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 62177) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO CDR.0000875) | 
| 207Q00000X Family Medicine (Licence: NV 20336) | |
| 207Q00000X Family Medicine (Licence: UT 11961125-1205) | |
| 207Q00000X Family Medicine (Licence: WI 53754) | |
| Enumeration Date | 2008-03-28 | 
| Last Update Date | 2024-12-13 |