NPI | 1912186628 |
---|---|
Entity Type | Organization |
Authorized Contact | TIM L WIGAL Clinical Professor 949-824-1812 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA psy14209) |
Enumeration Date | 2007-10-30 |
Last Update Date | 2007-11-07 |