| NPI | 1013307453 |
|---|---|
| Former Name | MICHELLE LEE GENTRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS58583) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PSI32696) |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2018-10-05 |