Individual
HOA BUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4547 HIAWATHA, MINNEAPOLIS, MN 55406
(612) 722-4249
(612) 722-5713
Mailing address
4547 HIAWATHA, MINNEAPOLIS, MN 55406
(612) 722-4249
(612) 722-5713
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
124851
MN
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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