Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 71380-20 | WI |
NPI | 1356792022 |
---|---|
Provider Name | Vinay P Goswamy |
First Address | Middleton, WI 53562-5531 |
Second Address | Rochester, NY 14621-3001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2016 |
Last Update Date | 08/06/2021 |