| NPI | 1609818038 |
|---|---|
| Former Name | SHAUNA DIEFENDERFER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN201898) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 201898) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2018-05-15 |