Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 217797 | MA |
Y | 2080P0205X | Pediatric Endocrinologist | 88468 | ZZ |
NPI | 1306813332 |
---|---|
Provider Name | Dr. Jonathan Daniel Wasserman |
First Address | Toronto, ONTARIO M5G 1X8 |
Second Address | Toronto, ONTARIO M5G 1X8 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 01/10/2012 |