| NPI | 1255769071 |
|---|---|
| Former Name | AMANDA C ROUBIK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MN 11469) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MN 1996) |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2017-11-28 |