UPDATE: finally got the game to run for the first time.
I started looking into the NGX Updater process from my post above and found a few forum posts for a different game where multiple instances were showing up and the game would never launch.
They recommended a full uninstall + clean install of all the Nvidia drivers. Followed the steps in this reddit post:
Guide: How To cleanly reinstall your Nvidia Driver
Game now loads and seems to be running without issues so far ~30min past character creation.
This worked for me, thanks.
