| NPI | 1912769795 |
|---|---|
| Other Name | CALEB MICHAEL SPROUSE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0101286706) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2024-01-26 |
| Last Update Date | 2025-09-08 |