| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
|
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103G00000X Clinical Neuropsychologist |
| 103TA0700X Psychologist, Adult Development & Aging |
| 103TC1900X Psychologist, Counseling |
| 103TF0000X Psychologist, Family |
| 103TH0100X Psychologist, Health Service |
| 133NN1002X Nutritionist, Nutrition, Education |
| 171400000X Health & Wellness Coach |
| 174H00000X Health Educator |
| 372600000X Adult Companion |
| 373H00000X Day Training/Habilitation Specialist |
| 374U00000X Home Health Aide |
| 376J00000X Homemaker |
| Enumeration Date | 2021-06-17 |
| Last Update Date | 2022-10-22 |