| 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 | 2020-08-04 |