| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
|
| Primary Taxonomy | 174H00000X Health Educator |
| Additional Taxonomies | 171W00000X Contractor |
| 175F00000X Naturopath |
| 246Y00000X Spec/Tech, Health Info |
| 247200000X Technician, Other |
| 172V00000X Community Health Worker |
| 175L00000X Homeopath |
| 171000000X Military Health Care Provider |
| 1744R1102X Specialist, Research Study |
| 101YP1600X Counselor, Pastoral |
| 246YC3302X Spec/Tech, Health Info, Coding Specialist, Physician Office Based |
| 246ZA2600X Specialist/Technologist, Other, Art, Medical |
| 174400000X Specialist |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2016-02-16 |