Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 2301004172 | MI |
NPI | 1518018415 |
---|---|
Provider Name | Dr. Dino F Kotsonis |
First Address | Clinton Township, MI 48035-3210 |
Second Address | Clinton Township, MI 48035-3210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 08/07/2007 |