Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | E12352 | AR |
NPI | 1023471885 |
---|---|
Provider Name | Priyenka Thapa |
First Address | Little Rock, AR 72205-5406 |
Second Address | Little Rock, AR 72205-5406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2016 |
Last Update Date | 07/10/2021 |