NPI | 1639341795 |
---|---|
Former Name | GENEVIE LOREE SHARP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 53754) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 62177) |
207Q00000X Family Medicine (Licence: CO CDR.0000875) | |
207Q00000X Family Medicine (Licence: NV 20336) | |
207Q00000X Family Medicine (Licence: UT 11961125-1205) | |
Enumeration Date | 2008-03-28 |
Last Update Date | 2021-04-29 |