Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 11221 | HI |
N | 208600000X | Surgeon | 11221 | HI |
N | 2082S0105X | Plastic Hand Surgeon | 11221 | HI |
NPI | 1386632412 |
---|---|
Provider Name | Dr. Dallas William Homas |
First Address | Apo, AE 09244 |
Second Address | Apo, AE 09244 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 08/07/2007 |