{
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"EnumerationDate": "10/12/2021",
"LastUpdateDate": "08/11/2025",
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"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
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"LicenseNumber": "097176",
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"PrimaryTaxonomySwitch": "Y"
}
},
"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."
}
}
}
}