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 | 202D00000X | Integrative Medicine | | | | Yes |
| 2 | 204C00000X | Neuromusculoskeletal Medicine, Sports Medicine | | | | No |
| 3 | 204D00000X | Neuromusculoskeletal Medicine & OMM | | | | No |
| 4 | 207K00000X | Allergy & Immunology | | | | No |
| 5 | 207PS0010X | Emergency Medicine | Sports Medicine | | | No |
| 6 | 207RC0000X | Internal Medicine | Cardiovascular Disease | | | No |
| 7 | 207RE0101X | Internal Medicine | Endocrinology, Diabetes & Metabolism | | | No |
| 8 | 207RP1001X | Internal Medicine | Pulmonary Disease | | | No |
| 9 | 207SG0201X | Medical Genetics | Clinical Genetics (M.D.) | | | No |
| 10 | 207XX0005X | Orthopaedic Surgery | Sports Medicine | | | No |
| 11 | 208200000X | Plastic Surgery | | | | No |
| 12 | 2083S0010X | Preventive Medicine | Sports Medicine | | | No |
| 13 | 2083T0002X | Preventive Medicine | Medical Toxicology | | | No |
| 14 | 2084P0301X | Psychiatry & Neurology | Brain Injury Medicine | | | No |
| 15 | 261QM1300X | Clinic/Center | Multi-Specialty | | | No |