Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | MD459443 | PA |
NPI | 1124409826 |
---|---|
Provider Name | Mr. Sanjog Kalra |
First Address | Philadelphia, PA 19141 |
Second Address | Philadelphia, PA 19141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2015 |
Last Update Date | 06/01/2017 |