{
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"FirstLineMailingAddress": "8568 ROAD F6",
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"FirstLinePracticeLocationAddress": "950 S MAIN ST STE 4",
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"EnumerationDate": "05/16/2025",
"LastUpdateDate": "05/16/2025",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
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"Taxonomies": {
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"LicenseNumber": "A.02581",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}