| NPI | 1467684183 |
|---|---|
| Former Name | LIYA ELIZABETH MATHEW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2011039208) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.027987) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2013-11-26 |