| NPI | 1467439745 |
|---|---|
| Other Name | JOE MICHAEL MACK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 58275) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE CP1090) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 17609C) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO CDR.0004506) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2025-03-08 |