| NPI | 1972474054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENNAN FORWARD Co Owner 218-790-6111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology |
| Enumeration Date | 2025-09-13 |
| Last Update Date | 2025-11-12 |