{
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"FirstLineMailingAddress": "1459 18TH STREET",
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"FirstLinePracticeLocationAddress": "730 22ND STREET #4",
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"PracticeLocationAddressCityName": "SAN FRANCISCO",
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"PracticeLocationAddressCountryCode": "US",
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"EnumerationDate": "01/09/2021",
"LastUpdateDate": "09/22/2025",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": "M",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Massage Therapist",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}