| Regimental number | 12402 |
| Place of birth | Adelaide South Australia |
| Religion | Jewish |
| Occupation | Florist |
| Address | 1 Nimmo Street, Middle Park, Victoria |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Sister, Miss D S Simmons, 1 Nimmo Street, Middle Park, Victoria |
| Enlistment date | 6 September 1915 |
| Rank on enlistment | Private |
| Unit name | Field Ambulance 10 |
| AWM Embarkation Roll number | 26/53/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A54 Runic on 20 June 1916 |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 10th Field Ambulance |
| Fate | Returned to Australia 10 June 1919 |