| NPI | 1417185216 |
|---|---|
| Former Name | TERESA ISHAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA 20A11447) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2018-03-17 |