NPI | 1619900537 |
---|---|
Other Name | HOWARD CLARENCE WILLIS |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 030693) |
Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: GA 030693) |
Enumeration Date | 2006-07-07 |
Last Update Date | 2024-08-07 |