Individual
MR. FAISALE SALE BOUKARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
12017 PENNSYLVANIA AVE N, CHAMPLIN, MN 55316-2233
(612) 281-5754
Mailing address
12017 PENNSYLVANIA AVE N, CHAMPLIN, MN 55316-2233
(612) 281-5754
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R 185771-5
MN
Other
Enumeration date
07/17/2010
Last updated
07/17/2010
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