| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
|
| Primary Taxonomy | 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies |
| Additional Taxonomies | 335G00000X Medical Foods Supplier |
| 374T00000X Religious Nonmedical Nursing Personnel |
| 347E00000X Transportation Broker |
| 372600000X Adult Companion |
| 3747P1801X Technician, Personal Care Attendant |
| 374K00000X |
| 175T00000X Peer Specialist |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies |
| 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2019-02-11 |