{
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"FirstLineMailingAddress": "3170 KETTERING BLVD BLDG B2ND",
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"MailingAddressCityName": "MORAINE",
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"FirstLinePracticeLocationAddress": "2451 WAYNE AVE",
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"PracticeLocationAddressCityName": "DAYTON",
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"PracticeLocationAddressTelephoneNumber": "937-208-7377",
"PracticeLocationAddressFaxNumber": "937-208-7375",
"EnumerationDate": "04/21/2015",
"LastUpdateDate": "05/13/2025",
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"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}