Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | MTL500001531 | DC |
NPI | 1619647138 |
---|---|
Provider Name | Dr. Evie Cassandra Landry |
First Address | Washington, DC 20005-4229 |
Second Address | Washington, DC 20010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2021 |
Last Update Date | 16/09/2021 |