| NPI | 1578834917 |
|---|---|
| Former Name | KATHERINA LUBA MANKO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704235399) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704235399) |
| Enumeration Date | 2012-01-17 |
| Last Update Date | 2017-10-18 |