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 | 204D00000X | Neuromusculoskeletal Medicine & OMM | | | | No |
| 2 | 207N00000X | Dermatology | | | | No |
| 3 | 207PE0005X | Emergency Medicine | Undersea and Hyperbaric Medicine | | | No |
| 4 | 207Q00000X | Family Medicine | | | | No |
| 5 | 207QB0505X | | | | | No |
| 6 | 207QS1201X | Family Medicine | Sleep Medicine | | | No |
| 7 | 207R00000X | Internal Medicine | | | | No |
| 8 | 207UN0901X | Nuclear Medicine | Nuclear Cardiology | | | No |
| 9 | 2083B0002X | Preventive Medicine | Obesity Medicine | | | No |
| 10 | 208D00000X | General Practice | | | | No |
| 11 | 207RC0000X | Internal Medicine | Cardiovascular Disease | | | Yes |