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 | 2082S0099X | Plastic Surgery | Plastic Surgery Within the Head and Neck | 77 154 | NEW MEXICO | No |
| 2 | 2086S0122X | Surgery | Plastic and Reconstructive Surgery | 77-154 | NEW MEXICO | No |
| 3 | 207YS0123X | Otolaryngology | Facial Plastic Surgery | 77-154 | NEW MEXICO | No |
| 4 | 207YX0007X | Otolaryngology | Plastic Surgery within the Head & Neck | 77-154 | NEW MEXICO | No |
| 5 | 207YX0905X | Otolaryngology | Otolaryngology/Facial Plastic Surgery | 77-154 | NEW MEXICO | Yes |