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 | 104100000X | Social Worker | | | | No |
| 2 | 207P00000X | Emergency Medicine | | | | No |
| 3 | 207Q00000X | Family Medicine | | | | No |
| 4 | 207R00000X | Internal Medicine | | | | Yes |
| 5 | 207T00000X | Neurological Surgery | | | | No |
| 6 | 207V00000X | Obstetrics & Gynecology | | | | No |
| 7 | 207X00000X | Orthopaedic Surgery | | | | No |
| 8 | 208000000X | Pediatrics | | | | No |
| 9 | 2080P0202X | Pediatrics | Pediatric Cardiology | | | No |
| 10 | 2080P0203X | Pediatrics | Pediatric Critical Care Medicine | | | No |
| 11 | 2080P0205X | Pediatrics | Pediatric Endocrinology | | | No |
| 12 | 2080P0206X | Pediatrics | Pediatric Gastroenterology | | | No |
| 13 | 2080P0207X | Pediatrics | Pediatric Hematology-Oncology | | | No |
| 14 | 2080P0208X | Pediatrics | Pediatric Infectious Diseases | | | No |
| 15 | 2080P0210X | Pediatrics | Pediatric Nephrology | | | No |