| NPI | 1114669074 |
|---|---|
| Former Name | TANNICE FOGARTHY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME182506) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2022-04-11 |
| Last Update Date | 2026-08-10 |