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 | 207NP0225X | Dermatology | Pediatric Dermatology | | | No |
| 2 | 2080H0002X | Pediatrics | Hospice and Palliative Medicine | | | No |
| 3 | 2080P0006X | Pediatrics | Developmental - Behavioral Pediatrics | | | No |
| 4 | 2080P0201X | Pediatrics | Pediatric Allergy/Immunology | | | No |
| 5 | 2080P0205X | Pediatrics | Pediatric Endocrinology | | | No |
| 6 | 2080P0206X | Pediatrics | Pediatric Gastroenterology | | | No |
| 7 | 2080P0207X | Pediatrics | Pediatric Hematology-Oncology | | | No |
| 8 | 2080P0208X | Pediatrics | Pediatric Infectious Diseases | | | No |
| 9 | 2080P0210X | Pediatrics | Pediatric Nephrology | | | No |
| 10 | 2080P0216X | Pediatrics | Pediatric Rheumatology | | | No |
| 11 | 2084N0402X | Psychiatry & Neurology | Neurology with Special Qualifications in Child Neurology | | | No |
| 12 | 237600000X | Audiologist-Hearing Aid Fitter | | | | No |
| 13 | 363LP0200X | Nurse Practitioner | Pediatrics | | | No |
| 14 | 208000000X | Pediatrics | | | | Yes |