{
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"FirstLineMailingAddress": "9829 YELLOW CUP DR",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "816-607-8433",
"FirstLinePracticeLocationAddress": "9829 YELLOW CUP DR",
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"EnumerationDate": "05/23/2025",
"LastUpdateDate": "05/23/2025",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OYEBANJI",
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"AuthorizedOfficialTelephoneNumber": "576-232-5044",
"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}