Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 207N00000X | Dermatology | | | | Yes |
| 2 | 207ND0101X | Dermatology | MOHS-Micrographic Surgery | | | No |
| 3 | 207ND0900X | Dermatology | Dermatopathology | | | No |
| 4 | 207NP0225X | Dermatology | Pediatric Dermatology | | | No |
| 5 | 207NS0135X | Dermatology | Procedural Dermatology | | | No |
| 6 | 207YS0123X | Otolaryngology | Facial Plastic Surgery | | | No |
| 7 | 207YX0007X | Otolaryngology | Plastic Surgery within the Head & Neck | | | No |
| 8 | 207YX0905X | Otolaryngology | Otolaryngology/Facial Plastic Surgery | | | No |
| 9 | 208200000X | Plastic Surgery | | | | No |
| 10 | 2082S0099X | Plastic Surgery | Plastic Surgery Within the Head and Neck | | | No |