{
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"FirstLineMailingAddress": "1148 WOODTRACE LN",
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"MailingAddressCityName": "AUBURN",
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"FirstLinePracticeLocationAddress": "1150 PEACHTREE INDUSTRIAL BLVD STE 165",
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"EnumerationDate": "08/20/2018",
"LastUpdateDate": "08/20/2018",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "NEMORIN",
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"AuthorizedOfficialCredential": "ESTHETICIAN",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Dermatology Physician",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}