{
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"FirstLineMailingAddress": "2848 2ND ST S STE 185",
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"FirstLinePracticeLocationAddress": "7270 FORESTVIEW LN N STE 160",
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"PracticeLocationAddressTelephoneNumber": "763-432-3386",
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"EnumerationDate": "04/21/2021",
"LastUpdateDate": "11/25/2024",
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"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
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}
},
"HealthcareProviderTaxonomyGroups": null
}
}