| 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 |