Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 12879 | NV |
Y | 2080P0203X | Pediatric Critical Care Doctor | 12878 | NV |
NPI | 1265681258 |
---|---|
Provider Name | Aretas Braziunas |
First Address | Las Vegas, NV 89109-2218 |
Second Address | Reno, NV 89502-1576 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2008 |
Last Update Date | 15/09/2008 |