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If you are looking for a way to save on your prescription costs, you may be wondering if a price reduction on Sildenafil citrate 100mg is possible. Sildenafil citrate is the active ingredient in Viagra, and is used to treat erectile dysfunction and pulmonary arterial hypertension. The patent for Viagra expires in 2020, which means that generic versions of the drug will become available. This could lead to a significant reduction in the cost of Sildenafil citrate.

In addition to the expiration of the Viagra patent, there are a number of other factors that could lead to a reduction in the price of Sildenafil citrate. For example, the FDA has recently approved a generic version of Viagra, which is made by Teva Pharmaceuticals. This could lead to increased competition in the market, which could drive down prices. In addition, the FDA has also approved a new use for Viagra, which is to treat erectile dysfunction in men who have undergone prostate surgery. This could lead to increased demand for the drug, and could also put downward pressure on prices.

If you are interested in getting a price reduction on Sildenafil citrate, you may want to talk to your doctor or pharmacist. They may be able to offer you a discount if you purchase the drug through their office. You may also want to check with your insurance company to see if they offer any discounts for Viagra. Finally, you can check online to see if any pharmacies are offering discounts on the drug.

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Kamagra is a medication used to treat erectile dysfunction (ED). It is a phosphodiesterase type 5 (PDE5) inhibitor. Kamagra increases blood flow to the penis, allowing more blood to enter the penis, resulting in an erection.

Kamagra is available as a tablet, oral jelly, and effervescent tablet. The recommended dose is 50 mg taken as needed, about 1 hour before sexual activity. The maximum recommended dose is 100 mg. Kamagra can be taken with or without food.

If you are taking Kamagra for the first time, it is important to start with the lowest dose and increase the dose only if necessary. Kamagra may not work as well if you take it with a high-fat meal.

Kamagra is generally well tolerated. The most common side effects are headache, flushing, and upset stomach. Kamagra is not recommended for use in children.

If you have any questions about Kamagra, please talk to your doctor or pharmacist.

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Sildenafil citrate is a white to off-white crystalline powder with a solubility of 3.5 mg/mL in water and a molecular weight of 666.7. The mean apparent volume of distribution following oral administration is 105 L, indicating distribution into the tissues.

Sildenafil is rapidly absorbed. Maximum observed plasma concentrations are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state. When sildenafil is taken with a high-fat meal, the rate of absorption is reduced, with a mean delay in Tmax of 60 minutes and a mean reduction in Cmax of 29%. The mean steady state volume of distribution (Vss) for sildenafil is 105 L, indicating distribution into the tissues.

Sildenafil and its major circulating N-desmethyl metabolite are both approximately 96% bound to plasma proteins. Protein binding is independent of total drug concentrations.

Metabolism and Excretion

Sildenafil is cleared predominantly by the CYP3A4 (major route) and CYP2C9 (minor route) hepatic microsomal isoenzymes. The major circulating metabolite results from N-desmethylation of sildenafil, and is itself further metabolized. This metabolite has a PDE selectivity profile similar to sildenafil and an in vitro potency for PDE5 approximately 50% of the parent drug. Plasma concentrations of this metabolite are approximately 40% of those seen for sildenafil, so that the metabolite accounts for about 20% of sildenafil's pharmacologic effects.

Excretion of sildenafil into human milk

There are no adequate and well-controlled studies of sildenafil in pregnant women.

Nursing Mothers

Because many drugs are excreted in human milk, caution should be exercised when sildenafil is administered to a nursing woman.

Pediatric Use

Safety and effectiveness of sildenafil in pediatric patients have not been established.

Geriatric Use

Of the total number of subjects in clinical trials of sildenafil, 18% were 65 years and older, while 2% were 75 years and older. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.

Renal Impairment

No dose adjustment is required for mild (CLcr=50–80 mL/min) and moderate (CLcr=30–49 mL/min) renal impairment. In volunteers with severe renal impairment (Clcr<30 mL/min), sildenafil clearance was reduced, resulting in higher plasma exposure of sildenafil (2.5-fold), increased maximum concentration (Cmax), and prolonged half-life (t1/2) of sildenafil. A starting dose of 25 mg should be considered in patients with severe renal impairment [see Dosage and Administration (2.5), Use in Specific Populations (8.7), and Clinical Pharmacology (12.3)].

Hepatic Impairment

In volunteers with hepatic impairment (Child-Pugh Class A and B), sildenafil clearance was reduced, resulting in higher plasma exposure of sildenafil (twofold), increased maximum concentration (Cmax), and prolonged half-life (t1/2) of sildenafil. A starting dose of 25 mg should be considered in patients with mild hepatic impairment [see Dosage and Administration (2.5), Use in Specific Populations (8.6), and Clinical Pharmacology (12.3)].

Sildenafil is not indicated for use in children.

Safety and effectiveness of sildenafil have not been established in pediatric patients.

In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

Sildenafil is rapidly absorbed. Maximum observed plasma concentrations are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state. When sildenafil is taken with a high-fat meal, the rate of absorption is reduced, with a mean delay in Tmax of 60 minutes and a mean reduction in Cmax of 29%. The mean steady state volume of distribution (Vss) for sildenafil is 105 L, indicating distribution into the tissues.

Sildenafil and its major circulating N-desmethyl metabolite are both approximately 96% bound to plasma proteins. Protein binding is independent of total drug concentrations.

Metabolism and Excretion

Sildenafil is cleared predominantly by the CYP3A4 (major route) and CYP2C9 (minor route) hepatic microsomal isoenzymes. The major circulating metabolite results from N-desmethylation of sildenafil, and is itself further metabolized. This metabolite has a PDE selectivity profile similar to sildenafil and an in vitro potency for PDE5 approximately 50% of the parent drug. Plasma concentrations of this metabolite are approximately 40% of those seen for sildenafil, so that the metabolite accounts for about 20% of sildenafil's pharmacologic effects.

Excretion of sildenafil into human milk

There are no adequate and well-controlled studies of sildenafil in pregnant women.

Nursing Mothers

Because many drugs are excreted in human milk, caution should be exercised when sildenafil is administered to a nursing woman.

Pediatric Use

Safety and effectiveness of sildenafil in pediatric patients have not been established.

Geriatric Use

Of the total number of subjects in clinical trials of sildenafil, 18% were 65 years and older, while 2% were 75 years and older. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.

Renal Impairment

No dose adjustment is required for mild (CLcr=50–80 mL/min) and moderate (CLcr=30–49 mL/min) renal impairment. In volunteers with severe renal impairment (Clcr<30 mL/min), sildenafil clearance was reduced, resulting in higher plasma exposure of sildenafil (2.5-fold), increased maximum concentration (Cmax), and prolonged half-life (t1/2) of sildenafil. A starting dose of 25 mg should be considered in patients with severe renal impairment [see Dosage and Administration (2.5), Use in Specific Populations (8.7), and Clinical Pharmacology (12.3)].

Hepatic Impairment

In volunteers with hepatic impairment (Child-Pugh Class A and B), sildenafil clearance was reduced, resulting in higher plasma exposure of sildenafil (twofold), increased maximum concentration (Cmax), and prolonged half-life (t1/2) of sildenafil. A starting dose of 25 mg should be considered in patients with mild hepatic impairment [see Dosage and Administration (2.5), Use in Specific Populations (8.6), and Clinical Pharmacology (12.3)].

Sildenafil is not indicated for use in children.

Safety and effectiveness of sildenafil have not been established in pediatric patients.

In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

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Kamagra 100mg is a popular medication used to treat erectile dysfunction (ED) in men. It is a generic version of the popular brand-name drug Viagra, and is available at a much lower price. Kamagra 100mg is a phosphodiesterase type 5 (PDE5) inhibitor, which works by increasing blood flow to the penis during sexual stimulation. This helps men achieve and maintain an erection.

Kamagra 100mg is available in several forms, including tablets, oral jelly, and effervescent tablets. The tablets are taken orally with water, while the jelly and effervescent tablets are dissolved in water before being taken. The recommended dose is 100mg, taken about 30 minutes before sexual activity. It is important to note that Kamagra 100mg should not be taken more than once per day.

Kamagra 100mg is a safe and effective medication for ED, and is available at a much lower price than Viagra. It is important to note that Kamagra 100mg is not a cure for ED, and it does not increase sexual desire. It is also important to discuss any potential side effects with a doctor before taking Kamagra 100mg. Common side effects include headaches, flushing, indigestion, nasal congestion, and dizziness.

Kamagra 100mg is a great option for those looking for a cost-effective treatment for ED. It is important to discuss any potential side effects with a doctor before taking Kamagra 100mg. With proper use, Kamagra 100mg can help men achieve and maintain an erection, allowing them to enjoy a more satisfying sexual experience.

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Sildenafil citrate is a white to off-white crystalline powder with a solubility of 3.5 mg/mL in water and a molecular weight of 666.7. Sildenafil citrate is designated chemically as 1-[[3-(6,7-dihydro-1-methyl-7-oxo-3-propyl-1H-pyrazolo[4,3-d]pyrimidin-5-yl)-4-ethoxyphenyl]sulfonyl]-4-methylpiperazine citrate and has the following structural formula:

Sildenafil citrate is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). Sildenafil citrate is also marketed as Viagra for erectile dysfunction.

Sildenafil citrate is rapidly absorbed after oral administration, with a mean absolute bioavailability of 41% (range 25-63%). The pharmacokinetics of sildenafil are dose-proportional over the recommended dose range. It is eliminated predominantly by hepatic metabolism (mainly CYP3A4) and is converted to an active metabolite with properties similar to the parent, sildenafil. Both sildenafil and the metabolite have terminal half-lives of about 4 hours.

Sildenafil citrate is a weak inhibitor of the CYP isoforms 1A2, 2C9, 2C19, 2D6, 2E1 and 3A4 (IC50 >150 μM). The inhibition of PDE5 by sildenafil citrate results in an increase in cGMP levels in the corpus cavernosum.

Sildenafil citrate at recommended doses has no effect in the absence of sexual stimulation. When sexual stimulation causes local release of NO, inhibition of PDE5 by sildenafil causes increased levels of cGMP in the corpus cavernosum, resulting in smooth muscle relaxation and inflow of blood to the corpus cavernosum. Sildenafil citrate at recommended doses has no effect on visual acuity or contrast sensitivity.

In clinical pharmacology studies, sildenafil was shown to potentiate the hypotensive effect of nitrates. This is thought to result from the combined effects of nitrates and sildenafil on the nitric oxide/cGMP pathway. In a study of healthy male volunteers, co-administration of the endothelin antagonist, bosentan, an inducer of CYP3A4, CYP2C9 and possibly of CYP2C19, at steady state (125 mg twice a day) with sildenafil at steady state (80 mg three times a day) resulted in 62% and 55% decreases in sildenafil AUC and Cmax, respectively. Strong inhibitors of CYP3A4 such as ketoconazole or itraconazole could reduce sildenafil clearance.

Sildenafil citrate is excreted as metabolites predominantly in the feces (about 80% of administered oral dose) and to a lesser extent in the urine (around 13% of the administered oral dose).

Sildenafil citrate is a white to off-white crystalline powder with a solubility of 3.5 mg/mL in water and a molecular weight of 666.7. Sildenafil citrate is designated chemically as 1-[[3-(6,7-dihydro-1-methyl-7-oxo-3-propyl-1H-pyrazolo[4,3-d]pyrimidin-5-yl)-4-ethoxyphenyl]sulfonyl]-4-methylpiperazine citrate and has the following structural formula:

Sildenafil citrate is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). Sildenafil citrate is also marketed as Viagra for erectile dysfunction.

Sildenafil citrate is rapidly absorbed after oral administration, with a mean absolute bioavailability of 41% (range 25-63%). The pharmacokinetics of sildenafil are dose-proportional over the recommended dose range. It is eliminated predominantly by hepatic metabolism (mainly CYP3A4) and is converted to an active metabolite with properties similar to the parent, sildenafil. Both sildenafil and the metabolite have terminal half-lives of about 4 hours.

Sildenafil citrate is a weak inhibitor of the CYP isoforms 1A2, 2C9, 2C19, 2D6, 2E1 and 3A4 (IC50 >150 μM). The inhibition of PDE5 by sildenafil citrate results in an increase in cGMP levels in the corpus cavernosum.

Sildenafil citrate at recommended doses has no effect in the absence of sexual stimulation. When sexual stimulation causes local release of NO, inhibition of PDE5 by sildenafil causes increased levels of cGMP in the corpus cavernosum, resulting in smooth muscle relaxation and inflow of blood to the corpus cavernosum. Sildenafil citrate at recommended doses has no effect on visual acuity or contrast sensitivity.

In clinical pharmacology studies, sildenafil was shown to potentiate the hypotensive effect of nitrates. This is thought to result from the combined effects of nitrates and sildenafil on the nitric oxide/cGMP pathway. In a study of healthy male volunteers, co-administration of the endothelin antagonist, bosentan, an inducer of CYP3A4, CYP2C9 and possibly of CYP2C19, at steady state (125 mg twice a day) with sildenafil at steady state (80 mg three times a day) resulted in 62% and 55% decreases in sildenafil AUC and Cmax, respectively. Strong inhibitors of CYP3A4 such as ketoconazole or itraconazole could reduce sildenafil clearance.

Sildenafil citrate is excreted as metabolites predominantly in the feces (about 80% of administered oral dose) and to a lesser extent in the urine (around 13% of the administered oral dose).

.

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A Board Certified Pediatric Dentist. He graduated from the University of Maryland and studied pediatric dentistry at Childrens Memorial Hospital in Chicago, Ill. Dr. Scott follows his fathers footsteps in the practice of pediatric dentistry and helps manage their expanding practice.

Dr. Scott sees patients at the King of Prussia, Havertown (Broomall) and Ardmore offices.

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Ama Walley, DMD is a Board Certified General Dentist - Limited to Pediatrics. She is a graduate of the University of Pennsylvania School of Dentistry, and completed her residency at the Eastman Dental Institute, London. She also attained a BDS from University of Lagos, Nigeria and an FDS from the Royal College of Physicians & Surgeons in Glasgow, Scotland.

Dr. Walley sees patients at the King of Prussia and Havertown (Broomall) offices.

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Amita Patel, DMD is Board Certified in Pediatrics. She graduated from the Temple University School of Dentistry and completed her pediatric residency at St. Christopher's Hospital for Children.

Dr. Patel sees patients at the Ardmore and Havertown (Broomall) offices.

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Dr. Ruda completed his undergraduate studies at the University of Scranton and in 2005 received his DMD from the Temple University School of Dentistry. Dr. Ruda completed a residency at the Lancaster Cleft Palate Clinic in Lancaster, PA and is a 2009 graduate from the orthodontic program at the University of Pennsylvania School of Dental Medicine.

Bryan Ruda sees orthodontic patients at the King of Prussia and Havertown (Broomall) offices.

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Ibrahim Durra, DMD is a graduate of the University of Pennsylvania School of Dentistry, completed his pediatric residency at St. Christopher's Hospital for Children and a pediatric fellowship at the University of Illinois.

Dr. Durra sees patients at the King of Prussia, Chalfont (Highpoint) and Bethlehem offices.

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Jessica Guy, DMD is a Board Certified General Dentist - Limited to Pediatrics. She is a graduate of Temple University School of Dentistry. Dr. "Jess" got her start in family practice, but discovered the joys of working with children while providing care for pediatric patients of St. Luke's & Pocono Health System's dental clinics.

Dr. Jess sees patients at the King of Prussia, Chalfont (Highpoint), Allentown and Bethlehem offices.

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Michael Daley, DMD graduated from the Temple University School of Dentistry and completed his residency in pediatric dentistry at St. Christopher's Hospital for Children.

Dr. Mike sees patients at the Chalfont (Highpoint), Allentown and Bethlehem offices.

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Natalie De Barros, DMD is a Board Certified Pediatric Dentist. She is a graduate of the University of Pittsburgh and Temple University School of Dentistry. She completed her residency in pediatric dentistry at Temple University Episcopal Hospital.

Dr. DeBarros sees patients at the King of Prussia and Ardmore offices.

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Sreedevi Sheka, DDS is a board certified Pediatric Dentist. She graduated from Columbia University School of Dental Medicine in 2002 and completed her pediatric dental residency at Columbia University/New York Presbytarian Hospital in 2004. She is also a part-time clinical attending for the dental residency program at Lehigh Valley Hospital.

Dr. Sheka sees patients at the Bethlehem office.

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Neil L. Moscow, DDS is a diplomate of the American Academy of Pediatric Dentistry and Board certified in Pediatric Dentistry. He is a graduate of Temple University School of Dentistry and Penn State University. He completed a two year specialty program in Pediatric Dentistry at Children’s Hospital of Philadelphia, where he served as Chief Dental Resident. Dr. Moscow also participated in two two-year orthodontic programs from Straight Wire and Functional Orthodontics. He is currently an Clinical Associate Professor of Pediatric Dentistry at the University of Pennsylvania School of Dental Medicine and a staff dentist at Children’s Hospital of Philadelphia and Bryn Mawr Hospital. He served as Director of Pediatric Dentistry at the Medical College of Pennsylvania for ten years.

Dr. Moscow sees patients at the Havertown (Broomall) office.

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Dr. Erin Bauerle is a board-certified orthodontic specialist. She completed her undergraduate education at Villanova University and then attended Temple University to earn her Doctor of Dental Medicine degree. After graduating from dental school, Dr. Bauerle spent two additional years at Temple studying solely orthodontics. During her orthodontic residency, Dr. Bauerle earned a master’s degree in Oral Biology and a Certificate in Orthodontics. Additionally, Dr. Bauerle has a background in general and pediatric dentistry. She spent an extra year furthering her education in a general practice residency. During this time Dr. Bauerle placed and restored dental implants, placed crowns and bridges, designed partial dentures, and helped patients with periodontal (gum) disease improve their oral health. This expertise will be used to help the treatment planning process for those of you who will need further dental work after your braces are removed. Prior to specializing as an orthodontist, Dr. Bauerle worked full time for a local pediatric dental practice and performed dentistry on children of all ages, including those with special needs. Dr. Bauerle believes she is privileged to be a member of the dental profession and enjoys giving back by sharing her time and knowledge. She is a faculty member at Temple Dental School’s Orthodontic Department. Locally, Dr. Bauerle has organized and participated in events such as Give Kids a Smile and Special Olympics Healthy Smiles. She also traveled to Jamaica and provided dental care to a population there who did not readily have access to dental services.

Dr. Bauerle sees patients at the Ardmore, Broomall and King of Prussia offices.

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Dr. Katherine Peck graduated Magna Cum Laude from Syracuse University. While at Syracuse, she played on their D1 Women's Soccer team. She earned her Doctor of Dental Medicine degree with a specialty in Pediatric Dentistry from Temple University and was elected to the OKU Honor Society. Dr. Peck's favorite part about being a pediatric dentist is helping children overcome their dental fears. Her goal is to create a fun and relaxed environment so that children are excited to go see the dentist. Dr. Peck is a member of the American Academy of Pediatric Dentistry, the American Dental Association, the Pennsylvania Dental Association and the Philadelphia County Dental Society. When she’s not in the office, Dr. Peck enjoys traveling, reading, and spending time with family and friends.

Dr. Peck sees patients in the King of Prussia and Highpoint offices.

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Marc Virtue, DDS graduated from the New York University College of Dentistry where he received his Doctor of Dental Surgery degree. Dr. Marc then completed two years of general practice residency; One year at New York Presbyterian/Weill Cornell Medical College and one year at Stony Brook University. He received his Pediatric Dentistry certificate from NYU College of Dentistry.

Dr. Marc sees patients at the King of Prussia, Ardmore, Pottstown, Allentown and Havertown (Broomall) offices.

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Dr. Dana DiGerolamo is a board certified pediatric dentist. She graduated from the University of Pennsylvania School of Dental Medicine in 2008. Along with her dental degree, she earned a Masters in Bioethics in the dual degree program. In 2009, she completed a 1 year general practice residency at Abington Memorial Hospital. Upon completion of her post doc training, she went out into private practice performing general dentistry, while providing care for children and special needs. She then pursued her pediatric dental residency with NYU Langone Dental Medicine at their Eastern Shore of Maryland site and graduated in 2013. During her residency, she fulfilled a 1 month externship in Hawaii on the west coast of Oahu treating an indigenous population. When she is not working , Dr. Dana enjoys spending time with her family, live music and traveling. She is married and has a daughter.

Dr. DiGerolamo sees patients at the King of Prussia and Allentown offices.

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Dr. Devin is a graduate of The Pennsylvania State University where she received a B.S. in Kinesiology. Following her undergraduate studies, she attended the University of Pittsburgh School of Dental Medicine where she earned her Doctor of Dental Medicine degree. Dr. Devin then completed her pediatric residency at St. Christopher’s Hospital for Children. When Dr. Devin is not working she likes spending time with her family and friends, trying new restaurants, and cheering on the Penn State Nittany Lions and Philadelphia Eagles football teams.

Dr. Devin sees patients at our Allentown, PA office.

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Dr. Marcela has 25 years of experience and is a dental graduate of Javeriana University in Colombia and the University of Pennsylvania School of Dental Medicine. Upon her arrival to the States, she completed a Pediatric Dental residency program as Chief Resident at St. Christopher's Hospital for Children. Dr. Marcela continued her education and completed a fellowship in Leadership Education in Neurodevelopmental and Related Disabilities (LEND) at Children's Hospital of Philadelphia. Throughout her career, she has served as a Pediatric Dental Clinical Instructor and Lecturer for her alma mater, in addition to the Temple University of Dentistry. She is an active member of the American Academy of Pediatric Dentistry and in her spare time enjoys dancing, traveling to beach destinations, and spending time with her children.

Dr Herrera sees patients at the King of Prussia, Pottstown, Chalfont (Highpoint) and Allentown offices. Dr Herrera is bilingual- she speaks English and Spanish.