NPI | 1104086271 |
---|---|
Former Name | ROBYN LEE DERANGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: LA MD.203151) |
Additional Taxonomies | 208600000X Surgery (Licence: LA MD.203151) |
Enumeration Date | 2008-06-12 |
Last Update Date | 2018-09-28 |