| 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: NH 13504) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A82298) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD431705) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2021-01-13 |