| Regimental number | 13945 |
| Place of birth | Kasan Russia |
| Religion | Church of England |
| Occupation | Engine driver |
| Address | Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 30 |
| Enlistment date | 9 August 1915 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A61 Kanowna on 1 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 8th Field Ambulance |
| Fate | Returned to Australia 19 October 1917 |
| Date of death | 29 July 1956 |
| Place of burial | Fawkner Cemetery |
