| NPI | 1386153724 |
|---|---|
| Former Name | CARRIE LEIGH CUBBERLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601009462) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60794994) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2021-08-25 |