| NPI | 1992940407 |
|---|---|
| Other Name | SONJAY JOSEPH FONN SOLE MEMBER |
| Entity Type | Organization |
| Authorized Contact | SONJAY JOSEPH FONN Single Member/Owner 573-651-1687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2020-11-18 |