Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | MN |
NPI | 1073935367 |
---|---|
Provider Name | Mr. Ibrahim Munye Abu-Munye |
First Address | Minneapolis, MN 55404-3258 |
Second Address | Minneapolis, MN 55404-3258 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2014 |
Last Update Date | 06/01/2014 |