Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | 036111013 | IL |
Y | 207RG0300X | Geriatric Medicine | 29074 | AL |
NPI | 1164439576 |
---|---|
Provider Name | Caroline Nobuko Harada |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35249-2503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 11/03/2019 |