Bank Loan, Lines of Credit and Loan Payable - Additional Information (Detail) - USD ($)			12 Months Ended
	Oct. 03, 2018	Mar. 03, 2017	Dec. 31, 2018	Sep. 21, 2018	Sep. 05, 2018	Sep. 01, 2018	Jun. 27, 2018	Jun. 14, 2018	Dec. 31, 2017	Oct. 31, 2017	Dec. 31, 2010
Short-term Bank Loans and Notes Payable			$ 40,257						$ 510,391
Line of Credit Facility, Maximum Borrowing Capacity		$ 6,700,000
Long-term Line of Credit			$ 5,000,000
Line of Credit Facility, Description	The letter of credit expires on December 31, 2019 and is deemed automatically extended without amendment for additional one - year periods from the present or any future expiration date, unless notified by the institution to terminate prior to 90 days from any expiration date.	The letter of credit expired on December 31, 2018 and is deemed automatically extended without amendment for additional one - year periods from the present or any future expiration date, unless notified by the institution to terminate prior to 90 days from any expiration date.
ICC [Member]
Debt Instrument, Face Amount											$ 4,600,000
Debt Instrument, Interest Rate, Stated Percentage			5.50%						4.50%
Short-term Bank Loans and Notes Payable			$ 40,257						$ 510,391
APC [Member]
Long-term Line of Credit				$ 5,000,000						$ 5,000,000
APC [Member] | Standby Letters of Credit [Member]
Line of Credit Facility, Maximum Borrowing Capacity			$ 300,000
NMM Business Loan Agreement [Member]
Line of Credit Facility, Maximum Borrowing Capacity								$ 20,000,000
Line of Credit Facility, Interest Rate at Period End			5.625%						4.625%
Line of Credit Facility, Expiration Date			Jun. 22, 2020
Long-term Line of Credit			$ 13,000,000	$ 5,000,000			$ 8,000,000		$ 5,000,000
Line of Credit Facility, Remaining Borrowing Capacity			$ 700,000						$ 8,300,000
Line of Credit Facility, Description			prime rate plus 0.125%
Line of Credit Facility, Guarantee Given by Related Parties			$ 5.0
NMM Business Loan Agreement [Member] | Minimum [Member]
Line of Credit Facility, Maximum Borrowing Capacity						$ 20,000,000
NMM Business Loan Agreement [Member] | Maximum [Member]
Line of Credit Facility, Maximum Borrowing Capacity						$ 27,000,000
APC Business Loan Agreement [Member]
Line of Credit Facility, Maximum Borrowing Capacity								$ 10,000,000
Line of Credit Facility, Interest Rate at Period End			5.625%						4.625%
Line of Credit Facility, Remaining Borrowing Capacity			$ 9,700,000						$ 9,700,000
Line of Credit Facility, Description			prime rate plus 0.125%
APAACO [Member]
Line of Credit Facility, Maximum Borrowing Capacity	$ 6,600,000
APAACO [Member] | Standby Letters of Credit [Member]
Line of Credit Facility, Expiration Date			Dec. 31, 2018
Net work Medical Management [Member]
Line of Credit Facility, Maximum Borrowing Capacity					$ 20,000,000
Line of Credit Facility, Interest Rate at Period End			5.625%
Line of Credit Facility, Remaining Borrowing Capacity			$ 20,000,000
Line of Credit Facility, Description			prime rate plus 0.125%