Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | A25784 | CA |
NPI | 1578502514 |
---|---|
Provider Name | Frank David Rollo |
First Address | Windsor, CT 06095-1540 |
Second Address | Windsor, CT 06095-1540 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 11/09/2007 |