| NPI | 1154382083 |
|---|---|
| Other Name | TREY BLUE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: LA MD.200727) |
| Additional Taxonomies | 208800000X Urology (Licence: FL FL#TRN4689) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2011-10-23 |