{
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"FirstLinePracticeLocationAddress": "7347 BELL CREEK RD STE 200",
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"EnumerationDate": "11/01/2006",
"LastUpdateDate": "01/08/2026",
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"NPIReactivationDate": null,
"GenderCode": "M",
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"Taxonomies": {
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}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}