| NPI | 1619900537 |
|---|---|
| Other Name | HOWARD CLARENCE WILLIS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: GA 030693) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 030693) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2016-01-07 |