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 | 207Q00000X | Family Medicine | | | | Yes |
| 2 | 207R00000X | Internal Medicine | | | | No |
| 3 | 207RC0000X | Internal Medicine | Cardiovascular Disease | | | No |
| 4 | 207T00000X | Neurological Surgery | | | | No |
| 5 | 207V00000X | Obstetrics & Gynecology | | | | No |
| 6 | 207X00000X | Orthopaedic Surgery | | | | No |
| 7 | 207Y00000X | Otolaryngology | | | | No |
| 8 | 2080P0206X | Pediatrics | Pediatric Gastroenterology | | | No |
| 9 | 2080P0207X | Pediatrics | Pediatric Hematology-Oncology | | | No |
| 10 | 208600000X | Surgery | | | | No |
| 11 | 2086S0120X | Surgery | Pediatric Surgery | | | No |
| 12 | 208800000X | Urology | | | | No |
| 13 | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | | | | No |
| 14 | 225100000X | Physical Therapist | | | | No |
| 15 | 2471M1202X | Radiologic Technologist | Magnetic Resonance Imaging | | | No |