| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
|
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 172A00000X Driver |
| 222Q00000X Developmental Therapist |
| 224Z00000X Occupational Therapy Assistant |
| 225100000X Physical Therapist |
| 225200000X Physical Therapy Assistant |
| 2255A2300X Specialist/Technologist, Athletic Trainer |
| 225X00000X Occupational Therapist |
| 2355S0801X Specialist/Technologist, Speech-Language Assistant |
| 235Z00000X Speech-Language Pathologist, |
| 3747A0650X Technician, Attendant Care Provider |
| 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-05-14 |
| Last Update Date | 2016-05-14 |