Individual
DOROTHY BOMA IG-IZEVBEKHAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
985 GENEVA AVE N, OAKDALE, MN 55128-7409
(651) 731-8480
Mailing address
2855 EAGLE VALLEY CIR, WOODBURY, MN 55129-4264
(651) 702-9627
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
116557
MN
Other
Enumeration date
09/03/2011
Last updated
09/03/2011
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