| NPI | 1427619998 | 
|---|---|
| Former Name | MICHAELA MERRILL | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 83668-20)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-2024)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-25 | 
| Last Update Date | 2025-08-25 |