| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
|
| Primary Taxonomy | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| 174H00000X Health Educator |
| 246Y00000X Spec/Tech, Health Info |
| 247000000X Technician, Health Information |
| 247200000X Technician, Other |
| 251E00000X Home Health |
| 251V00000X Voluntary or Charitable |
| 261Q00000X Clinic/Center |
| 261QA0600X Clinic/Center, Adult Day Care |
| 261QH0100X Clinic/Center, Health Services |
| 291U00000X Clinical Medical Laboratory |
| 343900000X Non-emergency Medical Transport (VAN) |
| 372500000X Chore Provider |
| 372600000X Adult Companion |
| Enumeration Date | 2024-05-24 |
| Last Update Date | 2024-05-24 |