| NPI | 1598229718 |
|---|---|
| Professional Name | CLYDE RUSSELL BOSWELL |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11012607) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 25373) |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2023-03-16 |