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 | 2084P0800X | Psychiatry & Neurology | Psychiatry | | | No |
| 2 | 208600000X | Surgery | | | | No |
| 3 | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | | | | No |
| 4 | 208000000X | Pediatrics | | | | No |
| 5 | 2083P0011X | Preventive Medicine | Undersea and Hyperbaric Medicine | | | No |
| 6 | 2084N0400X | Psychiatry & Neurology | Neurology | | | No |
| 7 | 207RG0100X | Internal Medicine | Gastroenterology | | | No |
| 8 | 207RP1001X | Internal Medicine | Pulmonary Disease | | | No |
| 9 | 207T00000X | Neurological Surgery | | | | No |
| 10 | 207X00000X | Orthopaedic Surgery | | | | No |
| 11 | 207LP2900X | Anesthesiology | Pain Medicine | | | No |
| 12 | 207P00000X | Emergency Medicine | | | | No |
| 13 | 207R00000X | Internal Medicine | | | | No |
| 14 | 207RE0101X | Internal Medicine | Endocrinology, Diabetes & Metabolism | | | No |
| 15 | 207Q00000X | Family Medicine | | | | Yes |