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 | 2081S0010X | Physical Medicine & Rehabilitation | Sports Medicine | | | No |
| 2 | 208100000X | Physical Medicine & Rehabilitation | | | | No |
| 3 | 207T00000X | Neurological Surgery | | | | No |
| 4 | 207XS0106X | Orthopaedic Surgery | Hand Surgery | | | No |
| 5 | 207XX0005X | Orthopaedic Surgery | Sports Medicine | | | No |
| 6 | 207XS0117X | Orthopaedic Surgery | Orthopaedic Surgery of the Spine | | | No |
| 7 | 207XX0004X | Orthopaedic Surgery | Foot and Ankle Surgery | | | No |
| 8 | 363A00000X | Physician Assistant | | | | No |
| 9 | 2085R0202X | Radiology | Diagnostic Radiology | | | No |
| 10 | 204C00000X | Neuromusculoskeletal Medicine, Sports Medicine | | | | Yes |