Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | MT222202 | PA |
N | 207R00000X | Internist | D0082521 | MD |
N | 111NI0900X | Internist | D0082521 | MD |
NPI | 1366856692 |
---|---|
Provider Name | Jasmine Toor |
First Address | Philadelphia, PA 19104-4319 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2014 |
Last Update Date | 16/07/2021 |