{
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"FirstLineMailingAddress": "12923 NW CORNELL RD STE 203",
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"EnumerationDate": "08/19/2015",
"LastUpdateDate": "03/01/2022",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "OLMA",
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"AuthorizedOfficialTelephoneNumber": "702-540-1333",
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{
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},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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},
{
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}
]
}
}
}