Individual
ETIETOP UBAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7801 OLD BRANCH AVE, CLINTON, MD 20735-1608
(240) 559-7353
Mailing address
7801 OLD BRANCH AVE STE 405, CLINTON, MD 20735-1644
(240) 559-7353
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R263408
MD
Other
Enumeration date
04/24/2026
Last updated
04/24/2026
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