NPI | 1518996628 |
---|---|
Professional Name | JESSICA MARIE WANCHALK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA052551) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052551) |
Enumeration Date | 2006-07-01 |
Last Update Date | 2014-08-19 |