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Individual
KASSIA ROSE FORTUNA
Active
Individual
KASSIA ROSE FORTUNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50.002798
OH
363A00000X
Physician Assistant
Primary
PA08840
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
351018201
—
TX
Enumeration date
09/03/2008
Last updated
12/10/2015
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