Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 1016 | WV |
NPI | 1780292698 |
---|---|
Provider Name | Hussein Jaffal |
First Address | Morgantown, WV 26506 |
Second Address | Morgantown, WV 26506-1200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2020 |
Last Update Date | 13/08/2021 |