| NPI | 1295344604 |
|---|---|
| Former Name | PORTIA BOATWRIGHT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11010453) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: FL 9322322) |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2021-03-07 |