Individual
ABDIRIZAK IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
127 W LAKE ST, MINNEAPOLIS, MN 55408-3141
(952) 649-1046
Mailing address
127 W LAKE ST, MINNEAPOLIS, MN 55408-3141
(952) 649-1046
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
P1236165405210
MN
Other
Enumeration date
12/28/2015
Last updated
12/28/2015
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