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 | 207LP2900X | Anesthesiology | Pain Medicine | | | No |
| 2 | 207Q00000X | Family Medicine | | | | No |
| 3 | 207R00000X | Internal Medicine | | | | Yes |
| 4 | 207RC0000X | Internal Medicine | Cardiovascular Disease | | | No |
| 5 | 207RP1001X | Internal Medicine | Pulmonary Disease | | | No |
| 6 | 207RX0202X | Internal Medicine | Medical Oncology | | | No |
| 7 | 207V00000X | Obstetrics & Gynecology | | | | No |
| 8 | 208000000X | Pediatrics | | | | No |
| 9 | 2084N0400X | Psychiatry & Neurology | Neurology | | | No |
| 10 | 2084P0800X | Psychiatry & Neurology | Psychiatry | | | No |
| 11 | 208D00000X | General Practice | | | | No |
| 12 | 363A00000X | Physician Assistant | | | | No |
| 13 | 363L00000X | Nurse Practitioner | | | | No |
| 14 | 364SA2100X | Clinical Nurse Specialist | Acute Care | | | No |