| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
|
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 171400000X Health & Wellness Coach |
| 171M00000X Case Manager/Care Coordinator |
| 171W00000X Contractor |
| 171WH0202X Contractor, Home Modifications |
| 172A00000X Driver |
| 174H00000X Health Educator |
| 251B00000X Case Management |
| 251E00000X Home Health |
| 251S00000X |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| 343900000X Non-emergency Medical Transport (VAN) |
| 347C00000X Private Vehicle |
| 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2024-03-28 |
| Last Update Date | 2024-04-24 |