Intangible Assets - Summary of Intangible Assets (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets [Line Items]
Beginning balance	$ 257,023,858	$ 216,377,135
Additions through asset acquisitions and adjustments (note 4)	18,622,130	40,646,723
Ending balance	275,645,988	257,023,858
Beginning balance	77,639,595	46,249,720
Amortization expense and adjustments (note 4)	34,898,200	31,389,875
Ending balance	112,537,795	77,639,595
Net balance	163,108,193	179,384,263
Professional Services Agreements [Member]
Finite-Lived Intangible Assets [Line Items]
Beginning balance	256,491,260	215,844,537
Additions through asset acquisitions and adjustments (note 4)	18,622,130	40,646,723
Ending balance	275,113,390	256,491,260
Beginning balance	77,139,732	45,752,303
Amortization expense and adjustments (note 4)	34,895,944	31,387,429
Ending balance	112,035,676	77,139,732
Net balance	163,077,714	179,351,528
Patents [Member]
Finite-Lived Intangible Assets [Line Items]
Beginning balance	532,598	532,598
Ending balance	532,598	532,598
Beginning balance	499,863	497,417
Amortization expense and adjustments (note 4)	2,256	2,446
Ending balance	502,119	499,863
Net balance	$ 30,479	$ 32,735