| NPI | 1215378955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONJAY JOSEPH FONN Owner 314-408-0129 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2024-10-26 |