NPI | 1053533919 |
---|---|
Former Name | SANJAY JOSEPH FONN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MO 2008003433) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 58.001982) |
Enumeration Date | 2007-05-02 |
Last Update Date | 2024-11-05 |