Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | 57595 | AZ |
NPI | 1386061257 |
---|---|
Provider Name | Lauren Marie Ogrich |
First Address | Scottsdale, AZ 85255-4140 |
Second Address | Scottsdale, AZ 85255 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2014 |
Last Update Date | 01/10/2020 |