Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 58802111205 | UT |
NPI | 1134158892 |
---|---|
Provider Name | Dr. Chara J. Solich |
First Address | Boise, ID 83712 |
Second Address | Boise, ID 83702-4565 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2006 |
Last Update Date | 27/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H89810 | (02) |