Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | LP02642 | RI |
Y | 2080P0201X | Pediatric Allergist | 2015-01090 | NC |
NPI | 1306081641 |
---|---|
Provider Name | Renee Georgia Stephanie Kleris |
First Address | Durham, NC 27710-3022 |
Second Address | Durham, NC 27710-3022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2008 |
Last Update Date | 25/06/2015 |