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Stock Option Plan - Stock Option Activity (Details) - Stock options - USD ($)
$ / shares in Units, $ in Thousands
 9 Months Ended 12 Months Ended
Sep. 30, 2023
Dec. 31, 2022
Number of Options    
Outstanding, beginning of period (in shares) 1,421,235  
Granted (in shares) 73,500  
Exercised (in shares) (93,335)  
Forfeited (in shares) (34,450)  
Expired (in shares) (362,095)  
Outstanding, end of period (in shares) 1,004,855 1,421,235
Vested and expected to vest, end of period (in shares) 1,004,855  
Options exercisable, end of period (in shares) 862,667  
Weighted- Average Exercise Price    
Outstanding, beginning of period (in dollars per share) $ 12.94  
Granted (in dollars per share) 3.04  
Exercised (in dollars per share) 0.26  
Forfeited (in dollars per share) 14.25  
Expired (in dollars per share) 17.00  
Outstanding, end of period (in dollars per share) 11.88 $ 12.94
Vested and expected to vest, end of period (in shares), Weighted Average Exercise Price (in dollars per share) 11.88  
Options exercised, end of period (in shares), Weighted Average Exercise Price (in dollars per share) $ 12.37  
Stock Options, Additional Disclosures [Abstract]    
Outstanding, Weighted Average Remaining Contractual Term 6 years 8 months 8 days 7 years 1 month 2 days
Vested and expected to vest, Weighted Average Remaining Contractual Term 6 years 8 months 8 days  
Options exercisable, Weighted Average Remaining Contractual Term 6 years 4 months 28 days  
Outstanding, Aggregate Intrinsic Value $ 286 $ 483
Vested and expected to vest, Aggregate Intrinsic Value 286  
Options exercisable, Aggregate Intrinsic Value $ 286