It is possible to write a MIDI file with no tempo information in it. If that's the case, it should play at the correct tempo when SONAR is set to 91BPM, regardless of whether you import it into an existing project at that tempo or open/import it into a project with some other tempo and change it to 91.
But you mentioned in your OP that the tempo is "all over the place", so I'm thinking that means you're going to have some work to do to align the timeline to it in any case.
How did you come up with the 91 figure? Is that what Pianoteq was set to, and you played to a click but did not keep good time?
If the standalone Pianoteq can render audio, importing the audio into SONAR will allow you to use Audiosnap or Set Measure/Beat At Now to figure out what the tempo really is.