| NPI | 1245947332 |
|---|---|
| Doing Business As | FAIRFAX ACNE & DERMATOLOGY, PC |
| Entity Type | Organization |
| Authorized Contact | DIANA L FAIRFAX Owner 508-404-3853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2022-10-31 |