Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD-14465 | HI |
Y | 208600000X | Surgeon | MD-14465 | HI |
NPI | 1003010265 |
---|---|
Provider Name | Dr. Daniel Robert Hudak |
First Address | Hilo, HI 96720-2060 |
Second Address | Hilo, HI 96720-2066 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2007 |
Last Update Date | 06/08/2008 |