{
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"FirstLineMailingAddress": "1199 N INDIAN CANYON DR STE A",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "1180 N PALM CANYON DR",
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"EnumerationDate": "03/06/2013",
"LastUpdateDate": "09/11/2023",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "ABDALLAH",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}